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Law VK, Lam AK. Effect of caffeine on superficial retinal vasculature of the macula in high myopes using optical coherence tomography angiography - A pilot study. JOURNAL OF OPTOMETRY 2022; 15:210-218. [PMID: 35637106 PMCID: PMC9237592 DOI: 10.1016/j.optom.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/13/2021] [Accepted: 06/18/2021] [Indexed: 06/15/2023]
Abstract
PURPOSE To monitor effect of caffeine on vasculature of the inner retina of high myopes METHODS: This was a crossover, self-control, randomized trial. Healthy young high myopes were recruited to take 200 mg of caffeine capsule and placebo capsule, randomly assigned in two visits separated by at least one week. Superficial retinal vasculature in terms of vessel length density (VD) and perfusion area density (PD) was captured and monitored using a spectral domain optical coherence tomography angiography (OCTA) machine. After baseline measurements, blood pressure (BP), intraocular pressure (IOP), and subfoveal choroidal thickness (ChT) were also monitored at 30-min intervals till 3 h. RESULTS Eighteen subjects (6 male, 24.3 ± 3.1 years) completed the study. After taking the caffeine capsule, there was a significant increase in BP (p < 0.01), and reduction in ChT (p < 0.01), with no change in IOP (p = 0.36). VD demonstrated a trend of reduction at the central 1-mm circle, and 1-3 mm annulus (p < 0.01) following the ETDRS grid. Reduction trend of PD appeared at the central 1-mm circle, 1-3 mm annulus, and the entire 3-mm circle (p < 0.01). Compared with baseline, VD and PD reductions were significant 180 min after taking the caffeine capsule at the central 1-mm circle, but the reduction was small (VD: by 1mm-1; PD: by 1%). Changes in other regions were not significant. CONCLUSIONS The current study found significant reduction in VD and PD after taking 200 mg of caffeine capsule. Such a small amount of alteration may be clinically irrelevant.
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Affiliation(s)
- Victoria Km Law
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Andrew Kc Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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Optical Coherence Tomography Angiography in Healthy Adult Subjects: Normative Values, Frequency, and Impact of Artifacts. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7286252. [PMID: 35295961 PMCID: PMC8920677 DOI: 10.1155/2022/7286252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/04/2022] [Accepted: 02/19/2022] [Indexed: 11/17/2022]
Abstract
Aim This cross-sectional study is aimed at identifying normative ocular coherence tomography angiography (OCTA) values in a cohort of healthy adult Jordanian individuals and assessing the prevalence of different image artifacts and their impact on quantitative OCTA measurements. Materials and Methods One hundred and eighty-one eyes from 100 healthy participants were included in this study. All participants underwent a comprehensive ophthalmological examination including best corrected visual acuity, slit lamp examination, and dilated fundoscopy. Swept-source OCTA images were obtained and analyzed for all 181 eyes. We recorded vascularity measurements and analyzed the prevalence and effect of ten different artifacts on superficial and deep retinal and choriocapillaris layer images. Results Sixty-two percent of the participants were men (n = 62), and 38% (n = 38) were women. The age of participants ranged between 24 and 75 years (mean 50.5 ± 10.92). The mean central macular thickness was 237.71 (±22.905) μm, and the mean choroidal thickness was 257.73 (±77.027) μm. Artifacts were present in 46.4% of the acquired scans. Images with artifacts had higher mean age (p = 0.03), lower image quality (p < 0.001), higher central vascular density (p < 0.001), and lower inferior vascular density (p < 0.001) compared to artifact-free tomographs. Motion artifact was the most common type, which was present in 29 (16%) of images, followed by blink artifact 18 (9.9%), and Z offset 8 (4.4%). Conclusion OCTA artifact detection and correction remains a challenging aspect of the diagnostic and follow-up process of patients with retinal pathologies. To our knowledge, this is the first study to examine the association between OCTA outputs and artifacts in healthy eyes. We report that in this cohort of normal individuals, images with artifacts had a significantly higher central vascular density (22.62 vs. 16.60) and a lower inferior vascular density (46.09 vs. 48.81). We also found that a significant increase in central vascular density is only present in images with Z offset artifact type (49.03). Motion artifact was the most common artifact seen in our series. However, we observed no alteration in quantitative parameters in images with motion artifacts.
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Arias JD, Arango FJ, Parra MM, Sánchez-Ávila RM, Parra-Serrano GA, Hoyos AT, Granados SJ, Viteri EJ, Gaibor-Santos I, Perez Y. Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography. Ther Adv Ophthalmol 2021; 13:25158414211047020. [PMID: 34708184 PMCID: PMC8543708 DOI: 10.1177/25158414211047020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Timely detection of early microvascular changes in patients with prediabetes
could help reduce the likelihood of progression of diabetes-related retinal
complications. Aim: To determine early microvascular changes in patients with prediabetes using
optical coherence tomography angiography (OCT-A). Methods: In this single-center retrospective case-control study, macular OCT-A images
of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were
analyzed in non-diabetic controls, and prediabetic and diabetic subjects. A
quantitative analysis was performed using ImageJ software of the foveal
avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD),
and vascular length density (VLD). Results: A total of 94 eyes of 53 patients were included in this study. The global
mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, the mean PD was
0.283 ± 0.15, 0.186 ± 0.720, and 0.186 ± 0.07 in non-diabetic controls, and
prediabetic and diabetic groups, respectively. The mean VLD was
8.728 ± 3.425 in non-diabetic controls, 6.147 ± 1.399 in prediabetic group,
and 6.292 ± 1.997 in patients with diabetes. The comparison of prediabetic
patients and controls shows statistical differences between PD and VLD in
both plexus SCP (p = 0.002 and p = 0.001,
respectively) and DCP (p = 0.005 and
p = 0.002, respectively). The mean area of FAZ in patients
with diabetes and normal individuals was 0.281 and 0.196 mm2,
respectively (p < 0.001). AI was higher in the control
group (0.87 ± 0.14) and prediabetic group (0.80 ± 0.17) compared to diabetic
patients (0.64 ± 0.19). There were no differences in FAZ area and AI between
prediabetic and non-diabetic controls. Conclusion: PD and VLD demonstrated to be early microvascular changes in prediabetic
patients evaluated by OCT-A. No alterations of FAZ were evidenced in this
group.
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Affiliation(s)
- Juan D Arias
- Foscal Internacional clinic, Universidad Autónoma de Bucaramanga (UNAB), Floridablanca, Colombia
| | | | - Maria Margarita Parra
- Fellow of Retina and Vitreous, Foscal Internacional clinic, Universidad Autónoma de Bucaramanga (UNAB), Cr 29 n° 16-23, Molinos Bajos, Floridablanca 681004, Colombia
| | - Ronald M Sánchez-Ávila
- Ophthalmological Research Foundation, Fernández-vega University Institute, University of Oviedo, Oviedo, Spain
| | | | | | | | - Eduardo J Viteri
- Foscal Internacional clinic, Universidad Autónoma de Bucaramanga (UNAB), Floridablanca, Colombia
| | - Ivetteh Gaibor-Santos
- Foscal Internacional clinic, Universidad Autónoma de Bucaramanga (UNAB), Floridablanca, Colombia
| | - Yanny Perez
- Pontificia Universidad Javeriana de Cali, Cali, Colombia
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Park MM, Young BK, Shen LL, Adelman RA, Del Priore LV. Topographic Variation of Retinal Vascular Density in Normal Eyes Using Optical Coherence Tomography Angiography. Transl Vis Sci Technol 2021; 10:15. [PMID: 34647965 PMCID: PMC8525867 DOI: 10.1167/tvst.10.12.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/10/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose To establish a continuous topography of retinal vessel density in normal eyes using optical coherence tomography angiography (OCTA). Methods A retrospective chart review was performed, and 8-mm × 8-mm OCTA images from 22 normal eyes were analyzed. Vessel density was plotted as a continuous function of distance from the foveal center (radial vessel density) and directional meridians (directional vessel density) for the superficial capillary plexus and deep capillary plexus. Results Continuous radial and directional vessel density plots for the superficial and deep capillary plexus were generated. Radial vessel density analysis revealed transition points at 657 microns (95% confidence interval [CI], 619-696) and 950 microns (95% CI, 903-997) from the foveal center for the superficial plexus and deep plexus, respectively. Directional vessel density analysis demonstrated significant vessel density variations in these vascular layers and provided greater detail compared to traditional quadrant analysis. Conclusions There are significant topographic variations of retinal vessel density in normal eyes. Continuous vessel density analysis offers greater sensitivity in detecting topographic vessel density changes compared to traditional methods of analysis. Translational Relevance This study establishes a normative continuous vessel density topography that may help elucidate the role of the vascular bed in different chorioretinal diseases.
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Affiliation(s)
- Michael M. Park
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
| | - Benjamin K. Young
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
| | - Liangbo L. Shen
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
| | - Ron A. Adelman
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
| | - Lucian V. Del Priore
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA
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Vujosevic S, Cunha-Vaz J, Figueira J, Löwenstein A, Midena E, Parravano M, Scanlon PH, Simó R, Hernández C, Madeira MH, Marques IP, C-V Martinho A, Santos AR, Simó-Servat O, Salongcay RP, Zur D, Peto T. Standardisation of Optical Coherence Tomography Angiography Imaging Biomarkers in Diabetic Retinal Disease. Ophthalmic Res 2021; 64:871-887. [PMID: 34348330 DOI: 10.1159/000518620] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - José Cunha-Vaz
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Figueira
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Anat Löwenstein
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Edoardo Midena
- Department of Neuroscience, University of Padua, Padua, Italy
| | | | - Peter Henry Scanlon
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria H Madeira
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Inês P Marques
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - António C-V Martinho
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Ana R Santos
- AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Olga Simó-Servat
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Recivall P Salongcay
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
- Eye and Vision Institute, The Medical City, Pasig, Philippines
| | - Dinah Zur
- Ophthalmology Division, Tel Aviv Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
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Multiple scan averaging to yield accurate quantitative analysis of optical coherence tomography angiograms. Sci Rep 2020; 10:6194. [PMID: 32277086 PMCID: PMC7148293 DOI: 10.1038/s41598-020-62956-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/20/2020] [Indexed: 12/19/2022] Open
Abstract
Optical coherence tomography angiography (OCTA) is widely used in ophthalmic practice. Most OCTA studies based their findings on a single OCTA measurement. We conducted an observational study of 82 eyes from 82 healthy subjects to compare variations of OCTA parameters among five successive measurements. A 3 × 3 mm Early Treatment of Diabetic Retinopathy Study grid centred at fovea was used. An average from five successive OCTA measurements (both perfusion density and vessel density) was calculated to be used as the reference standard. There was no significant difference in perfusion and vessel densities among five successive OCTA measurements, and from different levels of averaging. Perfusion density was close to the reference standard when average from three measurements was used (discrepancy within 1.5%) as compared with using just one measurement (discrepancy from 3.2% to 4.5%). Vessel density was also close to reference standard when average from three measurements was used (within 0.8 mm−1) as compared with using just one measurement (2 mm−1). Software feature that allows OCTA devices to average quantitative parameters for analysis will be useful.
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OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF THE FOVEAL AVASCULAR ZONE IN CHILDREN WITH A HISTORY OF TREATMENT-REQUIRING RETINOPATHY OF PREMATURITY. Retina 2020; 39:111-117. [PMID: 29190231 DOI: 10.1097/iae.0000000000001937] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the characteristics of the foveal vascular structure of patients with retinopathy of prematurity (ROP) by optical coherence tomography angiography. METHODS Ten patients with a history of laser photocoagulation or cryopexy treatment for Stage 3 (Zone ≥ II) ROP and 10 normal subjects (controls) were included. Foveal avascular zone, vessel density, vessel length, and vascular diameter index were measured by optical coherence tomography angiography using the 3 × 3-mm Early Treatment Diabetic Retinopathy Study (ETDRS) sectors. RESULTS The median foveal avascular zone values of the patients with ROP and controls were 0.103 mm and 0.260 mm, respectively (P = 0.0025). The medians of the vessel density, vessel length, and vascular diameter index of the patients with ROP were 0.218 mm/mm, 11.75 mm/mm, and 18.00 μm, respectively, in ETDRS Sector 1 and did not significantly differ from those of the controls (P = 0.940, 0.733, and 0.705, respectively). For the average of ETDRS Sectors 2 to 5, the medians of the vessel density, vessel length, and vascular diameter index for the patients with ROP were 0.347 mm/mm, 18.95 mm/mm, and 18.28 μm, respectively; vessel density and vessel length were significantly smaller than those of the controls (P = 0.002 and 0.003, respectively), but there was no significant difference in vascular diameter index (P = 0.286). CONCLUSION Optical coherence tomography angiography-guided foveal avascular zone was significantly smaller in patients with ROP than in controls. Our results indicate that foveal vascular development may be altered in patients with a history of treatment-requiring ROP.
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Reduced Peripapillary and Macular Vessel Density in Unilateral Postgeniculate Lesions With Retrograde Transsynaptic Degeneration. J Neuroophthalmol 2019; 39:462-469. [PMID: 31658224 DOI: 10.1097/wno.0000000000000794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Retrograde transsynaptic degeneration (RTSD) of the retinal ganglion cells and retinal nerve fiber layer after postgeniculate injury has been well documented, but to the best of our knowledge, associated retinal microvascular changes have not been examined. The purpose of our study was to assess vessel density (VD) at macular and peripapillary regions in patients with RTSD. METHODS Cross-sectional study including 16 patients with homonymous visual field defects secondary to unilateral postgeniculate visual pathway injury and 18 age-matched controls. All participants were examined with AngioVue optical coherence tomography angiography to measure the peripapillary vessel density and macular vessel density (pVD/mVD) as well as the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell complex (GCC) thicknesses. The pRNFL and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses also were evaluated using Cirrus OCT. A normalized asymmetry score (NAS) was calculated for GCIPL and GCC thickness, and mVD. RESULTS Average pRNFL and macular GCIPL/GCC thicknesses were significantly thinner in both eyes of patients compared with control eyes (all P ≤ 0.05). Eight patients (50%), who showed a RTSD of the GCIPL map, had a relative thinning of the GCIPL/GCC ipsilateral to the brain lesion in both eyes (represented by a positive GCIPL-NAS/GCC-NAS). The mean pVD and mVD also were significantly reduced in patients (all P ≤ 0.05). There was a strong correlation between GCIPL-NAS/GCC-NAS and mVD-NAS index in both eyes (all r > 0.7, P = 0.001). Furthermore, there was a similar spatial pattern of damage for the macular GCC thickness and VD values. CONCLUSIONS We demonstrated a significant VD decrease in peripapillary and macular areas of patients with RTSD because of postgeniculate lesions. The structural and microvascular asymmetry indexes were significantly correlated. These findings provide new insights regarding transsynaptic degeneration of the visual system.
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Shin YI, Kim JM, Lee MW, Jo YJ, Kim JY. Characteristics of the Foveal Microvasculature in Asian Patients with Dry Age-Related Macular Degeneration: An Optical Coherence Tomography Angiography Study. Ophthalmologica 2019; 243:145-153. [PMID: 31645037 DOI: 10.1159/000503295] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/09/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate changes in the foveal microvasculature in patients with dry age-related macular degeneration (dry AMD) using optical coherence tomography angiography (OCTA). METHODS Eighty-three eyes with dry AMD and 83 age- and sex-matched normal eyes were enrolled. A 3 × 3 mm2 OCTA (Zeiss HD-OCT 5000 with AngioPlex; Carl Zeiss Meditec, Dublin, CA, USA) scan was used to acquire images. Vessel density (VD), perfusion density (PD), and the foveal avascular zone (FAZ) of the superficial capillary plexus were analyzed. RESULTS The VD of the full area, central area, and inner ring of the dry AMD patients (18.61, 8.41, and 20.45, respectively) were significantly lower than those of the controls (20.06, 11.09, and 22.51, respectively). The PD of the full area, central area, and inner ring of the dry AMD patients (0.34, 0.15, and 0.37, respectively) were also significantly lower than those of the controls (0.36, 0.19, and 0.40, respectively). The FAZ area and perimeter in the dry AMD patients (0.29 mm2 and 2.47 mm, respectively) were larger than those in the controls (0.23 mm2 and 2.09 mm, respectively). The FAZ circularity index in the dry AMD patients was smaller than that in the controls (0.61 vs. 0.66). Using univariate linear regression, age, best-corrected visual acuity (BCVA), central macular thickness (CMT), and ganglion cell-inner plexiform layer (GC-IPL) thickness were associated with both VD and PD of the full area. Using multivariate analysis, only GC-IPL thickness was significantly associated with the VD and PD of the full area (p = 0.001 and p = 0.004, respectively). CONCLUSIONS OCTA revealed changes in the foveal microcirculation of patients with dry AMD. Age, BCVA, CMT, and GC-IPL thickness should be considered when analyzing the OCTA data of patients with dry AMD. GC-IPL thickness is particularly important during clinical evaluation of VD and PD in patients with dry AMD.
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Affiliation(s)
- Yong-Il Shin
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ju Mi Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Min-Woo Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Young-Joon Jo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea,
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Eastline M, Munk MR, Wolf S, Schaal KB, Ebneter A, Tian M, Giannakaki-Zimmermann H, Zinkernagel MS. Repeatability of Wide-field Optical Coherence Tomography Angiography in Normal Retina. Transl Vis Sci Technol 2019; 8:6. [PMID: 31106033 PMCID: PMC6502067 DOI: 10.1167/tvst.8.3.6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/25/2019] [Indexed: 12/04/2022] Open
Abstract
Purpose We evaluated the repeatability of wide-field en face swept-source optical coherence tomography angiography (SS-OCTA) in healthy subjects. Methods Healthy subjects underwent two imaging sessions, on average 8 days apart, with a 100 kHz SS-OCTA instrument. The imaging protocol included a central 3 × 3 and 12 × 12 mm scans of the four quadrants resulting in more than a 70° wide-field OCTA of the posterior pole. Quantitative analysis was performed using the inbuilt Macular Density Algorithm Version v0.6.1 and AngioTool software. Consistency for the foveal avascular zone (FAZ), vessel density, and perfusion density of the superficial and deep capillary plexus slabs and the wide-field OCTA superficial slab, and the number of artefacts on the wide-field images were assessed. Results A total of 21 healthy volunteers (seven men and 14 women; mean age 32 years; range, 18–61; standard deviation, 10.28 years) were included in this analysis. Internal consistency was highest for FAZ area with an intraclass correlation (ICC) = 0.998 (95% confidence interval [CI], 0.997–0.999), a FAZ perimeter with an ICC = 0.995 (95% CI, 0.990–0.997), a FAZ circularity with an ICC= 0.976 (95% CI, 0.956–0.987), followed by the vessel density of the inner ring in the superficial slab with an ICC = 0.834 (95% CI, 0.691–0.911), and a vessel density of the inner ring in the deep slab with an ICC = 0.523 (95% CI, 0.113–0.744). The reproducibility of the average vessels length of the wide-field OCTA cropped images was strong (ICC = 0.801; 95% CI, 0.624–0.895), followed by the reproducibility of total number of junctions (ICC = 0.795; 95% CI, 0.613–0.892) and the vessels percentage area (ICC = 0.662; 95% CI, 0.361–0.821). Conclusions The level of reproducibility for assessing the microvascular anatomy in wide-field OCTA is strong and can be used to quantify microvascular changes over time. Refinements in analysis strategies and a consensus of which parameters are most useful for quantitative assessment of wide-field OCTA images would be useful in the future. Translational Relevance These findings bridge the gap between basic imaging research and clinical use for quantitative wide-field OCTA.
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Affiliation(s)
- Michael Eastline
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland
| | - Marion R Munk
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Karen B Schaal
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Ebneter
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland
| | - Meng Tian
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland
| | - Helena Giannakaki-Zimmermann
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin S Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, and Department of BioMedical research, University of Bern, Bern, Switzerland.,Bern Photographic Reading Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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11
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Li Z, Zhang J, Lin T, Peng W, Lu L, Hu J. Macular vascular circulation and retinal oxygen saturation changes for idiopathic macular epiretinal membrane after vitrectomy. Acta Ophthalmol 2019; 97:296-302. [PMID: 30843354 DOI: 10.1111/aos.14066] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 02/02/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE To investigate the postoperative changes in retinal-choroidal blood flow area and retinal vascular oxygen saturation among patients with idiopathic macular epiretinal membranes (iERMs). METHODS This study prospectively included 24 eyes of 24 consecutive patients who underwent vitrectomy for iERMs. The flow area of choriocapillary layer, retinal superficial capillary plexuses (SCPs) and retinal deep capillary plexuses (DCPs) were performed using optical coherence tomography angiography with angiovue prototype software, and retinal vascular oxygen saturation was measured using retinal oximeter with the built-in software. The flow area of choriocapillary layers and mean retinal vessel oxygen saturation before and after surgery were compared. RESULTS Three months after vitrectomy, the foveal flow area of choriocapillary layer increased clinically significantly from 1.5 ± 0.2 to 1.6 ± 0.2 mm2 (p = 0.02). The retinal vascular changes of SCPs and DCPs were not statistically significant. The mean retinal arterial oxygen saturation was 89.9 ± 11.3% preoperatively and increased to 94.5 ± 9.7% postoperatively (p = 0.04). Foveal retinal thickness revealed a clinically significant decrease from 547.8 ± 88.2 μm to 403.0 ± 47.5 μm after surgery (p < 0.05). Postoperative best corrected visual acuity had no statistically significant correlation with foveal flow area of the choriocapillary layer and retinal vascular oxygen saturation. CONCLUSIONS There was a decrease of retinal thickness, an improved flow area of choriocapillary layer in macular region, and an increase of retinal arterial vascular oxygen among iERMs patients after vitrectomy.
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Affiliation(s)
- Zhixi Li
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Jie Zhang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Tao Lin
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Wenyan Peng
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Lin Lu
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Jie Hu
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
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Akil H, Karst S, Heisler M, Etminan M, Navajas E, Maberley D. Application of optical coherence tomography angiography in diabetic retinopathy: a comprehensive review. Can J Ophthalmol 2019; 54:519-528. [PMID: 31564340 DOI: 10.1016/j.jcjo.2019.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
Abstract
Optical coherence tomography angiography (OCTA) is a noninvasive method that enables visualization of blood flow within retinal vessels down to the size of capillaries by detecting motion contrast from moving blood cells. OCTA provides a fast and safe procedure to assess retinal microvasculature with higher contrast and resolution than conventional fluorescence angiography. The different capillary plexuses are displayed separately and their perfusion density can be quantified. Imaging capabilities such as these have led to an emerging field of clinical application for OCTA in vascular diseases such as diabetic retinopathy (DR). Evaluation of parameters such as parafoveal capillary perfusion density could be a biomarker for disease diagnosis and progression. Typical microvascular changes in DR such as capillary nonperfusion, microaneurysms, intraretinal microvascular abnormalities, and neovascularization can be reliably detected in optical coherence tomography angiograms, characterized in detail and attributed to the different capillary plexuses. Monitoring of these lesions in vivo gives potential novel insight into the pathophysiology in DR. The aim of this article is to summarize the potential applications/utility of OCTA in DR reported in the literature.
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Affiliation(s)
- Handan Akil
- Department of Ophthalmology, Faculty of Medicine, University of British Columbia, Vancouver, B.C
| | - Sonja Karst
- Department of Ophthalmology, Faculty of Medicine, University of British Columbia, Vancouver, B.C.; Department of Ophthalmology and Optometry, Medical University Vienna, Vienna, Austria
| | - Morgan Heisler
- Faculty of Applied Sciences, Simon Fraser University, Burnaby, B.C
| | - Mahyar Etminan
- Department of Ophthalmology, Faculty of Medicine, University of British Columbia, Vancouver, B.C
| | - Eduardo Navajas
- Department of Ophthalmology, Faculty of Medicine, University of British Columbia, Vancouver, B.C
| | - David Maberley
- Department of Ophthalmology, Faculty of Medicine, University of British Columbia, Vancouver, B.C..
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Chung CS, Nesper PL, Park JJ, Fawzi AA. Comparison of Zeiss Cirrus and Optovue RTVue OCT Angiography Systems: A Quantitative and Qualitative Approach Examining the Three Capillary Networks in Diabetic Retinopathy. Ophthalmic Surg Lasers Imaging Retina 2019; 49:e198-e205. [PMID: 30457656 DOI: 10.3928/23258160-20181101-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/25/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Construct a method for visualizing the middle capillary plexus (MCP) using Zeiss optical coherence tomography angiography (OCTA) and compare to established segmentation methods using the Optovue system. PATIENTS AND METHODS Twenty eyes with diabetic retinopathy were imaged. Visualization of the MCP, image artifacts, preservation of pathological changes, foveal avascular zone (FAZ) area, and vessel length density (VLD) were compared between devices. RESULTS The authors successfully segmented the superficial (SCP), MCP, and deep (DCP) capillary plexuses on both devices. More images artifacts were detected on Optovue. Microaneurysms and telangiectatic vessels were better visualized in the MCP on the Optovue. FAZ area showed a strong correlation between the two instruments (r2= 0.666; P < .0001). The SCP had lower VLD compared to the MCP and DCP on both devices. CONCLUSION The authors provide an objective and consistent method for manual segmentation using Zeiss OCTA to visualize the three retinal capillary plexuses. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e198-e205.].
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Anegondi N, Kshirsagar A, Mochi TB, Sinha Roy A. Quantitative Comparison of Retinal Vascular Features in Optical Coherence Tomography Angiography Images From Three Different Devices. Ophthalmic Surg Lasers Imaging Retina 2019; 49:488-496. [PMID: 30021035 DOI: 10.3928/23258160-20180628-04] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/02/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare optical coherence tomography angiography (OCTA) images from three different devices. PATIENTS AND METHODS This was a prospective, observational, cross-sectional study. All eyes (n = 24) were imaged thrice each time with swept-source OCT (DRI OCT Triton Plus; Topcon, Tokyo, Japan), spectral-domain OCTA (AngioVue; Optovue, Fremont, CA), and SD-OCT Angioplex (Cirrus HD-OCT 5000; Carl Zeiss Meditec, Jena, Germany). Outcome measures were foveal avascular zone (FAZ) area, vessel density, spacing between large vessels (SLV), and spacing between small vessels (SSV). They were calculated using local fractal analyses and Frangi filter. RESULTS The vascular parameters showed good to excellent repeatability (intraclass coefficient > 0.8) in the three devices. The FAZ area (P = .3) and vessel density of the superficial layer (P = .8) were similar between the devices. In the deep layer, vessel density was significantly higher (P = .02) with Angio-Vue images compared to those acquired using the other devices. However, SLV was significantly higher (P < .05) and SSV was significantly lower (P < .05) on Angioplex scans compared to other devices. Vessel parameters were significantly altered in Frangi-filtered images as compared to nonfiltered images. CONCLUSIONS Vessel density showed good repeatability among the three devices, although there were differences in vessel parameters between the devices. Also, vessel parameters changed significantly after Frangi filtering. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:488-496.].
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Giannakaki-Zimmermann H, Munk MR, Dysli C, Ebneter A, Wolf S, Zinkernagel MS. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF TORPEDO MACULOPATHY. Retin Cases Brief Rep 2019; 13:337-342. [PMID: 28375988 DOI: 10.1097/icb.0000000000000589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND/PURPOSE To investigate the retinal and choroidal vasculature in patients with torpedo maculopathy with optical coherence tomography-angiography (OCT-A). METHODS Retrospective case series of four patients who were examined at the department of Ophthalmology at the University Hospital Bern. Main Outcome was the lesion size over time in OCT-A and fundus autofluorescence. RESULTS Three patients had Type I and 1 patient had Type II torpedo maculopathy. Torpedo maculopathy lesion size remained stable in all patients over a mean period of observation of three years in OCT-A and fundus autofluorescence. The choriocapillaris network was attenuated focally within the lesion in OCT-A in all four cases. The lesion size in fundus autofluorescence was 2.77 mm and therefore comparable with the lesion size in OCT-A of 2.75 mm. CONCLUSION OCT-A signal of the choriocapillaris was reduced within the cleft in both types of torpedo maculopathy. Whether the changes represent the primary site of malformation or whether these findings are the consequence of a defect in the retinal pigment epithelium remains speculative.
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16
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Li XX, Wu W, Zhou H, Deng JJ, Zhao MY, Qian TW, Yan C, Xu X, Yu SQ. A quantitative comparison of five optical coherence tomography angiography systems in clinical performance. Int J Ophthalmol 2018; 11:1784-1795. [PMID: 30450309 DOI: 10.18240/ijo.2018.11.09] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/06/2018] [Indexed: 01/21/2023] Open
Abstract
AIM To compare the clinical performance of 4 spectral-domain (SD) optical coherence tomography angiography (OCTA) systems: AngioVue™, AngioPlex™, Spectralis® OCTA, AngioScan, and 1 swept-source (SS) OCTA SS OCT Angio™. METHODS Twenty-seven undilated right eyes of 27 participants underwent OCTA examination using five different systems respectively for both 3×3 and 6×6 mm2 scan pattern (Spectralis OCTA for 3×3 mm2 scan only). Image quality, including vessel valid visibility and the number of motion artifacts, and acquisition time were evaluated. Repeated measures analysis of variance (ANOVA) with Bonferroni's post-test and Friedman test with Dunn's post-test were used to compare measurements. RESULTS The age of the subjects was 28.19±5.55y (range, 23-49y). The spherical equivalent refraction was -2.55±1.84 D (range, 0.00 to -5.25 D). Significant difference was observed in the evaluation of vessel valid visibility (AngioVue the highest: 0.111±0.031 for 3×3 mm2 scan and 0.128±0.020 for 6×6 mm2 scan), number of motion artifacts (AngioVue the fewest: 0.778±1.086 for 3×3 mm2 scan and 0.333±0.620 for 6×6 mm2 scan) and acquisition time (AngioPlex the shortest: 8.537±1.921s for 3×3 mm2 scan and 8.298±1.741s for 6×6 mm2 scan; all P<0.001). CONCLUSION There is poor agreement of measurements among systems. AngioVue provides images with the highest vessel valid visibility and the fewest motion artifacts. AngioPlex achieves the shortest acquisition.
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Affiliation(s)
- Xin-Xin Li
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China.,Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Wei Wu
- Department of Mathematics, Eidgenössische Technische Hochschule Zürich, Zurich 8092, Switzerland
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China
| | - Jun-Jie Deng
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China.,Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Meng-Ya Zhao
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China.,Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Tian-Wei Qian
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China.,Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Chen Yan
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China.,Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai 200080, China
| | - Su-Qin Yu
- Department of Ophthalmology, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China
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Cataract significantly influences quantitative measurements on swept-source optical coherence tomography angiography imaging. PLoS One 2018; 13:e0204501. [PMID: 30278057 PMCID: PMC6168135 DOI: 10.1371/journal.pone.0204501] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/10/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose To analyze retinal blood flow before and after cataract surgery using swept-source optical coherence tomography angiography (SS-OCTA). Methods Prospective observational study. Consecutive patients were recruited and scanned using SS-OCTA before and after cataract surgery. Laser flare photometry were performed post-surgery. Perfusion and vessel density of superficial (SCP) and deep capillary plexuses (DCP) of the 3 × 3 mm images as well as foveal avascular zone (FAZ) measurements were assessed. Vessel continuity, vessel visibility and presence of artefacts were evaluated by two blinded graders using a predefined grading protocol. Results Thirteen eyes of 12 patients met the inclusion criteria. There was a significant increase of perfusion and vessel densities in both the SCP and the DCP after cataract surgery within the 3 × 3 mm images. Significantly better distinguishability of FAZ border was observed postoperatively in both SCP and DCP, however, FAZ area and perimeter measurements did not significantly change after cataract surgery. Mean number of motion artifacts in SCP and DCP numerically decreased by 37% (P = .089) and 42% (P = .080). Conclusions Lens opacities have a significant influence on retinal blood flow measurements in SS-OCTA and should be considered in quantitative vessel analysis. Inflammation may also impact the assessment of density parameters. FAZ measurements seems to be the most robust parameters in terms of media opacity.
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18
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Koyanagi Y, Murakami Y, Funatsu J, Akiyama M, Nakatake S, Fujiwara K, Tachibana T, Nakao S, Hisatomi T, Yoshida S, Ishibashi T, Sonoda KH, Ikeda Y. Optical coherence tomography angiography of the macular microvasculature changes in retinitis pigmentosa. Acta Ophthalmol 2018; 96:e59-e67. [PMID: 28561452 DOI: 10.1111/aos.13475] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 04/05/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate the macular microvasculature changes by optical coherence tomography angiography (OCTA) and analyse the correlation between these changes and central visual function in patients with retinitis pigmentosa (RP). METHODS We measured the area of the foveal avascular zone (FAZ) and the foveal and parafoveal flow density (FFD and PFD, respectively) in the superficial (S) and deep (D) retinal plexus by OCTA (AngioVue) and compared these values between 73 RP patients and 36 healthy controls. We analysed the relationships between these microvasculature measurements and central visual functions such as visual acuity (VA) and the values of static perimetry tests (Humphrey Field Analyzer, the central 10-2 program) in the RP patients. RESULTS The FFD-S, PFD-S and PFD-D were significantly decreased in the RP patients compared to the controls (all p < 0.05), whereas there was no significant difference in the FAZ-S, FAZ-D or FFD-D (all p > 0.05). A subgroup analysis showed that the RP patients with VA <20/20 had increased FAZ-S compared to the controls and RP patients with VA ≥20/20 (p = 0.01 and p = 0.007, respectively). Spearman rank testing demonstrated that PFD-S and PFD-D were significantly correlated with all of the central visual parameters (all p < 0.01). The FAZ-S and FFD-S were significantly correlated with VA, and FAZ-D and FFD-D showed no significant correlation. CONCLUSION Both the superficial and deep layers of the parafoveal microvasculature are attenuated in RP and correlated with reduced central visual function. The foveal microvasculature, especially in the deep layer, was relatively preserved until mild-to-moderately advanced stages.
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Affiliation(s)
- Yoshito Koyanagi
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yusuke Murakami
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Jun Funatsu
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Masato Akiyama
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
- Laboratory for Statistical Analysis; RIKEN Center for Integrative Medical Sciences; Kanagawa Japan
| | - Shunji Nakatake
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Kohta Fujiwara
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
- Department of Ophthalmology; Akita University Graduate School of Medicine; Akita Japan
| | - Takashi Tachibana
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Shintaro Nakao
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Toshio Hisatomi
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Shigeo Yoshida
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yasuhiro Ikeda
- Department of Ophthalmology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
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Munk MR, Giannakaki-Zimmermann H, Berger L, Huf W, Ebneter A, Wolf S, Zinkernagel MS. OCT-angiography: A qualitative and quantitative comparison of 4 OCT-A devices. PLoS One 2017; 12:e0177059. [PMID: 28489918 PMCID: PMC5425250 DOI: 10.1371/journal.pone.0177059] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 04/23/2017] [Indexed: 01/09/2023] Open
Abstract
Purpose To compare the quality of four OCT-angiography(OCT-A) modules. Method The retina of nineteen healthy volunteers were scanned with four OCT-devices (Topcon DRI-OCT Triton Swept-source OCT, Optovue RTVue-XR, a prototype Spectralis OCT2, Heidelberg-Engineering and Zeiss Cirrus 5000-HD-OCT). The device-software generated en-face OCT-A images of the superficial (SCP) and deep capillary plexuses (DCP) were evaluated and scored by 3 independent retinal imaging experts. The SCP vessel density was assessed using Angiotool-software. After the inter-grader reliability assessment, a consensus grading was performed and the modules were ranked based on their scoring. Results There was no significant difference in the vessel density among the modules (Zeiss 48.7±4%, Optovue 47.9±3%, Topcon 48.3±2%, Heidelberg 46.5±4%, p = 0.2). The numbers of discernible vessel-bifurcations differed significantly on each module (Zeiss 2±0.9 bifurcations, Optovue 2.5±1.2, Topcon 1.3±0.7 and Heidelberg 0.5±0.6, p≤0.001). The ranking of each module differed depending on the evaluated parameter. In the overall ranking, the Zeiss module was superior and in 90% better than the median (Bonferroni corrected p-value = 0.04). Optovue was better than the median in 60%, Topcon in 40% and Heidelberg module in 10%, however these differences were not statistically significant. Conclusion Each of the four evaluated OCT-A modules had particular strengths, which differentiated it from their competitors.
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Affiliation(s)
- Marion R. Munk
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Bern Photographic Reading Center, University of Bern, Switzerland
- * E-mail:
| | - Helena Giannakaki-Zimmermann
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Bern Photographic Reading Center, University of Bern, Switzerland
| | - Lieselotte Berger
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Clinical Research, Inselspital Bern University Hospital, University of Bern, Switzerland
| | - Wolfgang Huf
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Andreas Ebneter
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Clinical Research, Inselspital Bern University Hospital, University of Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Bern Photographic Reading Center, University of Bern, Switzerland
- Department of Clinical Research, Inselspital Bern University Hospital, University of Bern, Switzerland
| | - Martin S. Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Bern Photographic Reading Center, University of Bern, Switzerland
- Department of Clinical Research, Inselspital Bern University Hospital, University of Bern, Switzerland
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de Barros Garcia JMB, Isaac DLC, Avila M. Diabetic retinopathy and OCT angiography: clinical findings and future perspectives. Int J Retina Vitreous 2017; 3:14. [PMID: 28293432 PMCID: PMC5346852 DOI: 10.1186/s40942-017-0062-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/22/2017] [Indexed: 01/21/2023] Open
Abstract
In diabetic retinopathy (DR), macular involvement can present as either macular edema or ischemia. Fluorescein angiography remains the gold standard in the evaluation of retinal vascular perfusion and diagnosis of macular ischemia. However, it is a costly, time-consuming technique, it requires venipuncture, and reports of anaphylaxis and death related to fluorescein injections have been documented, despite their rarity. Optical coherence tomography (OCT) provides a fast and non-invasive method to assess retinal structures at a microscopic level. OCT angiography permits the noninvasive study of retinal and choroid circulation via motion contrast imaging. Split-spectrum amplitude decorrelation angiography combined with OCT angiography has furthered the understanding of retinal and choroidal vascular diseases, allowing the evaluation of retinal microvasculature and identification of subsequent disorders, including DR. Previous studies using OCT angiography have demonstrated that it may demonstrate DR findings such as microaneurysms, arteriolar wall staining, retinal neovascularization, and intraretinal microvascular abnormalities. The purpose of this article is to describe and discuss different concepts regarding OCT angiography, as well as its role in the diagnosis of DR and maculopathy.
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Affiliation(s)
| | - David Leonardo Cruvinel Isaac
- Federal University of Goias, Av. Primeira Avenida, S/N, Rua 234, 38, Apto 1011, Setor Leste Universitario, Goiania, GO CEP 74605-020 Brazil
| | - Marcos Avila
- Federal University of Goias, Av. Primeira Avenida, S/N, Rua 234, 38, Apto 1011, Setor Leste Universitario, Goiania, GO CEP 74605-020 Brazil
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