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Zinchuk M, Popova S, Guekht A, Shpak A. Optical coherence tomography angiography in patients with bipolar disorder and major depressive disorder. J Affect Disord 2024; 361:409-414. [PMID: 38889857 DOI: 10.1016/j.jad.2024.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 05/14/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Cerebral microvascular dysfunction is a promising area for research into the pathogenesis of major depressive disorder (MDD) and bipolar disorder (BD). Despite the scientific and clinical potential of studying microvascular dysfunction, progress in this area has long been hampered by the lack of methods to study microvessels intravitally. AIMS The aim of the present study was to search for potential optical coherence tomography (OCT) and OCT-angiography (OCTA) biomarkers of BD and MDD. METHODS One hundred and five consecutive patients with a current depressive episode were enrolled in the study (39 - BD and 66 - MDD). In addition, forty-one generally healthy subjects were enrolled as a control group. Only the right eye was examined in all subjects. Structural OCT and OCTA scans with signal strength ≥7 were included. RESULTS Structural OCT measurements showed no significant differences between the groups. OCTA measurements of foveal avascular zone (FAZ), area and skeleton density showed a decrease in the retinal capillary bed in BD patients, whereas OCTA values in MDD patients did not differ from the control group. Several significant differences were found between the BD and control groups. In the BD group, the FAZ of the deep capillary plexus was increased, reflecting a reduction in capillary perfusion in the central subfield of this plexus. CONCLUSIONS OCTA measurements of FAZ, area and skeleton density showed a decrease in the retinal capillary bed in BD patients, whereas OCTA values in MDD patients did not differ from the control group.
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Affiliation(s)
- Mikhail Zinchuk
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow Healthcare Department, Moscow, Russian Federation.
| | - Sofya Popova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow Healthcare Department, Moscow, Russian Federation
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow Healthcare Department, Moscow, Russian Federation; Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Alexander Shpak
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow Healthcare Department, Moscow, Russian Federation; S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
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Cao L, Wu J, Wang H, Kwapong WR, Yan Y, Wan J, Wang P, Liu G, Wang R, Hu F, Feng L, Wu B. Influence of Carotid Artery Stenting on the Retina and Choroid. Transl Vis Sci Technol 2024; 13:5. [PMID: 39093294 PMCID: PMC11305422 DOI: 10.1167/tvst.13.8.5] [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: 01/28/2024] [Accepted: 06/24/2024] [Indexed: 08/04/2024] Open
Abstract
Purpose The effect of carotid artery stenting in patients with unilateral carotid artery stenosis on the retina and choroid was evaluated using swept-source optical coherence tomography angiography (SS-OCTA). Methods SS-OCTA examination was conducted before stenting and 4 days and 3 months after stenting. The retinal nerve fiber layer, ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, superficial vascular complex (SVC), deep vascular complex (DVC), choroidal vascular volume (CVV), and choroidal vascular index were measured. Repeated-measures analysis of variance was performed to assess the impact of carotid artery stenting on optical coherence tomography angiography (OCTA) metrics. Results At baseline, 303 eyes from 160 patients (61.82 ± 9.98 years; 85.29% males) were enrolled. SVC and DVC densities and CVV were lower in ipsilateral eyes (stenosed side) compared to contralateral eyes (all P < 0.05). Four days after stenting, a significant increase was seen in SVC density in ipsilateral eyes (P < 0.05) while a significant increase was seen in CVV in ipsilateral eyes and contralateral eyes (both P < 0.05). Three months after stenting (63 patients with 114 eyes), a significant decrease was seen in the GCIPL thickness of ipsilateral and contralateral eyes (all P < 0.001). Conclusions Short term after carotid artery stenting, ipsilateral eyes showed a rapid and significant increase in SVC density and CVV. Translational Relevance Optical coherence tomography (OCT)/OCTA measurements may have the potential to detect retinal and choroidal changes after stenting. Future research on the long-term effect of stenting on the retina and choroid will be guided by these findings.
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Affiliation(s)
- Le Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Juan Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Yuying Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jincheng Wan
- Department of Respiratory and Critical Care Medicine, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Ping Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Guina Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Fayun Hu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Feng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Hou X, Jie C, Liu Z, Bi X, Deng Y, Li Y, Wang J, Zhang W. Changes in the retina and choroid in patients with internal carotid artery stenosis: a systematic review and meta-analysis. Front Neurosci 2024; 18:1368957. [PMID: 38686328 PMCID: PMC11056587 DOI: 10.3389/fnins.2024.1368957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/15/2024] [Indexed: 05/02/2024] Open
Abstract
Background Internal carotid artery stenosis (ICAS) is a prevalent vascular condition associated with ischemic cerebrovascular disease. The ophthalmic artery is the first branch of the internal carotid artery stenosis (ICA). Given the crucial role of the ICA in ocular perfusion, we aimed to assess the thickness and vessel density of the retina and choroid in individuals with ICAS. Methods The PubMed and Embase databases were searched from inception to 10 January 2023 for studies evaluating retinal and choroidal changes between ICAS patients and healthy controls using optical coherence tomography (OCT) or optical coherence tomography angiography (OCTA). Data of interest were extracted and analyzed using Stata software version 16. Results Thirteen studies involving 419 ICAS eyes and 398 healthy eyes were included. The pooled results demonstrated that the average thickness of peripapillary retinal nerve fiber layer (pRNFL) (WMD = -0.26, 95% CI: -0.45 to -0.08, P = 0.005), ganglion cell complex (GCC) (WMD = -0.36, 95% CI: -0.65 to -0.06, P = 0.017), and choroid (WMD = -1.06, 95% CI: -1.59 to -0.52, P = 0.000), were significantly thinner in patients with ICAS than in healthy controls. The overall vessel density of the radial peripapillary capillaries (RPC) in whole-image scans was lower in ICAS patients than in healthy control subjects (WMD = -0.94, 95% CI: -1.49 to -0.39, P = 0.001). No differences were detected in the vessel density of the superficial capillary plexus (SCP) (WMD = -0.84, 95% CI: -1.15 to -0.53, P = 0.092), the deep capillary plexus (DCP) (WMD = -0.27, 95% CI: -0.56 to 0.03, P = 0.074), or the choriocapillaris (CC) (WMD = -0.39, 95% CI: -1.12 to 0.35, P = 0.300). Conclusion This systematic review and meta-analysis demonstrated that ICAS can reduce the vessel density of the RPC and the thickness of the retina and choroid. The retinal and choroidal microvasculature is a potential biomarker of the initial signal of ICAS. Systematic review registration https://inplasy.com/, identifier NPLASY202410038.
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Affiliation(s)
| | - Chuanhong Jie
- Eye Hospital China Academy of Chinese Medical Sciences, Beijing, China
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Shen Z, Zhang S, Yu W, Yue M, Hong C. Optical Coherence Tomography Angiography: Revolutionizing Clinical Diagnostics and Treatment in Central Nervous System Disease. Aging Dis 2024:AD.2024.0112. [PMID: 38300645 DOI: 10.14336/ad.2024.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/12/2024] [Indexed: 02/02/2024] Open
Abstract
Optical coherence tomography angiography (OCTA), as a new generation of non-invasive and efficient fundus imaging technology, can provide non-invasive assessment of vascular lesions in the retina and choroid. In terms of anatomy and development, the retina is referred to as an extension of the central nervous system (CNS). CNS diseases are closely related to changes in fundus structure and blood vessels, and direct visualization of fundus structure and blood vessels provides an effective "window" for CNS research. This has important practical significance for identifying the characteristic changes of various CNS diseases on OCTA in the future, and plays a key role in promoting early screening, diagnosis, and monitoring of disease progression in CNS diseases. This article reviews relevant fundus studies by comparing and summarizing the unique advantages and existing limitations of OCTA in various CNS disease patients, in order to demonstrate the clinical significance of OCTA in the diagnosis and treatment of CNS diseases.
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Affiliation(s)
- Zeqi Shen
- Postgraduate training base Alliance of Wenzhou Medical University (Affiliated People's Hospital), Hangzhou, Zhejiang, China
| | - Sheng Zhang
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Weitao Yu
- The Second School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mengmeng Yue
- Postgraduate training base Alliance of Wenzhou Medical University (Affiliated People's Hospital), Hangzhou, Zhejiang, China
| | - Chaoyang Hong
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Zhu Z, Ji S, Liang L, Wang H, Xia H, Tang P. Hemodynamic study of blood flow in the aorta during the interventional robot treatment using fluid-structure interaction. Biomech Model Mechanobiol 2023; 22:1857-1872. [PMID: 37329426 PMCID: PMC10613174 DOI: 10.1007/s10237-023-01737-y] [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: 04/26/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
An interventional robot is a means for vascular diagnosis and treatment, and it can perform dredging, releasing drug and operating. Normal hemodynamic indicators are a prerequisite for the application of interventional robots. The current hemodynamic research is limited to the absence of interventional devices or interventional devices in fixed positions. Considering the coupling effect of blood, vessels and robots, based on the bi-directional fluid-structure interaction, using the computational fluid dynamics and particle image velocimetry methods, combined with the sliding and moving mesh technologies, we theoretically and experimentally study the hemodynamic indicators such as blood flow lines, blood pressure, equivalent stress, deformation and wall shear stress of blood vessels when the robot precesses, rotates or does not intervene in the pulsating blood flow. The results show that the intervention of the robot increase the blood flow rate, blood pressure, equivalent stress and deformation of the vessels by 76.4%, 55.4%, 76.5%, and 346%, respectively. The operating mode of the robot during low-speed operation has little impact on the hemodynamic indicators. Using the methyl silicone oil as the experimental fluid, the elastic silicone pipe as the experimental pipe, and the intervention robot having a bioplastic outer shell, the velocity of the fluid around the robot is measured on the developed experimental device for fluid flow field in a pulsating flow when the robot runs. The experimental results are similar to the numerical results. Our work provides an important reference for the hemodynamic study and optimization of the mobile interventional devices.
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Affiliation(s)
- Zongming Zhu
- College of Electromechanical Engineering, Changsha University, Changsha, 410022, China
| | - Suqiang Ji
- School of Mechanical Engineering and Mechanics, Xiangtan University, Xiangtan, 411105, China
| | - Liang Liang
- College of Electromechanical Engineering, Changsha University, Changsha, 410022, China.
| | - Hao Wang
- College of Engineering and Design, Hunan Normal University, Changsha, 410081, China
| | - Haoyu Xia
- Changsha Institute of Mining Research Co., LTD, Changsha, 410012, China
| | - Puhua Tang
- College of Electromechanical Engineering, Changsha University, Changsha, 410022, China
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Batu Oto B, Kılıçarslan O, Kayadibi Y, Yılmaz Çebi A, Adaletli İ, Yıldırım SR. Retinal Microvascular Changes in Internal Carotid Artery Stenosis. J Clin Med 2023; 12:6014. [PMID: 37762953 PMCID: PMC10531601 DOI: 10.3390/jcm12186014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Purpose: We aimed to analyze retinal microvascular parameters, measured by optical coherence tomography angiography in patients with internal carotid artery stenosis compared to healthy individuals. Materials and Methods: A total of 41 eyes from 30 patients who had varying degrees of carotid stenosis, and 42 eyes from 42 healthy controls, were enrolled in this study. Depending on the degree of stenosis evaluated by Doppler ultrasonographic imaging, the patient group was further subclassified into mild, moderate, and severe carotid artery stenosis. Superficial and deep capillary plexus vessel densities, radial peripapillary capillary vessel density, foveal avascular zone, and flow densities in the choriocapillaris and outer retina were evaluated by optical coherence tomography angiography. Results: The superficial and deep capillary plexus vessel densities were significantly reduced among the groups, only sparing the foveal region. The mean superficial plexus vessel density was 45.67 ± 4.65 and 50.09 ± 4.05 for the patient and control group, respectively (p = 0.000). The mean deep capillary plexus density was 46.33% ± 7.31% and 53.27% ± 6.31% for the patient and control group, respectively (p = 0.000). The mean superficial and deep capillary vessel densities in the foveal region did not show any statistical difference between the patient and control groups (p = 0.333 for the superficial and p = 0.195 for the deep plexus vessel density). Radial peripapillary capillary vessel density was decreased in the patient group (p = 0.004). The foveal avascular zone area was wider in the patient group but this difference did not show a significant difference (p = 0.385). Conclusions: Retinal microvascular changes are a prominent outcome of internal carotid disease, and even mild stenosis can lead to alterations in the retinal microvascular bed which could be detected by OCTA. By early detection of microvascular changes in the retina in this patient group, we might speculate the overall vascular condition.
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Affiliation(s)
- Bilge Batu Oto
- Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 345098 Istanbul, Turkey
| | | | - Yasemin Kayadibi
- Department of Radiology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpasa, 345098 Istanbul, Turkey
| | - Aslıhan Yılmaz Çebi
- Department of Ophthalmology, Çerkezköy State Hospital, 59500 Tekirdağ, Turkey
| | - İbrahim Adaletli
- Department of Radiology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpasa, 345098 Istanbul, Turkey
| | - Senihe Rengin Yıldırım
- Department of Ophthalmology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 345098 Istanbul, Turkey
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Cao L, Wang H, Kwapong WR, Wang R, Liu J, Wu B. Length of Carotid Plaque Impacts Retinal Microvascular Densities of Carotid Artery Stenosis Patients. Transl Vis Sci Technol 2023; 12:3. [PMID: 37672253 PMCID: PMC10484014 DOI: 10.1167/tvst.12.9.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose We explored the retinal microvascular changes in carotid artery stenosis (CAS) and their relationship with carotid plaque morphology. Methods All participants were diagnosed with carotid artery stenosis by a neurologist. Participants underwent digital subtraction angiography (DSA) and optical coherence tomography angiography (OCTA) imaging. The degree and length of carotid plaque were obtained from the DSA tool. OCTA tool measured the densities in the superficial vascular complex (SVC) and deep vascular complex (DVC). Results One hundred seventeen patients with CAS patients were included in our data analysis. Eyes with ipsilateral stenosis had reduced retinal microvascular densities when compared to contralateral eyes in patients with CAS (P = 0.016 for SVC, and P = 0.004 for DVC). Microvascular densities correlated with the length of carotid plaque (P = 0.015 for SVC, and P = 0.022 for DVC) in our CAS cohort, although they did not correlate with the degree of carotid plaque (P = 0.264 for SVC, and P = 0.298 for DVC). However, when stratified into moderate and severe subgroups, the degree of carotid plaque correlated with microvascular densities in patients with severe stenosis (P = 0.045 for SVC, and P = 0.038 for DVC). Conclusions Our study suggests that OCTA can noninvasively detect retinal microvascular changes in patients with CAS and that these changes correlated with the length of the stenosis, but future studies are required to confirm these findings. Translational Relevance Noninvasive and rapid acquisition of the OCTA image might have the potential to be used as a screening tool to detect microvascular changes in carotid artery stenosis.
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Affiliation(s)
- Le Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hang Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - William Robert Kwapong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruilin Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junfeng Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Li B, Leng J, Şencan-Eğilmez I, Takase H, Alfadhel MAH, Fu B, Shahidi M, Lo EH, Arai K, Sakadžić S. Differential reductions in the capillary red-blood-cell flux between retina and brain under chronic global hypoperfusion. NEUROPHOTONICS 2023; 10:035001. [PMID: 37323511 PMCID: PMC10266089 DOI: 10.1117/1.nph.10.3.035001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/13/2023] [Accepted: 04/26/2023] [Indexed: 06/17/2023]
Abstract
Significance It has been hypothesized that abnormal microcirculation in the retina might predict the risk of ischemic damages in the brain. Direct comparison between the retinal and the cerebral microcirculation using similar animal preparation and under similar experimental conditions would help test this hypothesis. Aim We investigated capillary red-blood-cell (RBC) flux changes under controlled conditions and bilateral-carotid-artery-stenosis (BCAS)-induced hypoperfusion, and then compared them with our previous measurements performed in the brain. Approach We measured capillary RBC flux in mouse retina with two-photon microscopy using a fluorescence-labeled RBC-passage approach. Key physiological parameters were monitored during experiments to ensure stable physiology. Results We found that under the controlled conditions, capillary RBC flux in the retina was much higher than in the brain (i.e., cerebral cortical gray matter and subcortical white matter), and that BCAS induced a much larger decrease in capillary RBC flux in the retina than in the brain. Conclusions We demonstrated a two-photon microscopy-based technique to efficiently measure capillary RBC flux in the retina. Since cerebral subcortical white matter often exhibits early pathological developments due to global hypoperfusion, our results suggest that retinal microcirculation may be utilized as an early marker of brain diseases involving global hypoperfusion.
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Affiliation(s)
- Baoqiang Li
- Chinese Academy of Sciences, Shenzhen Institute of Advanced Technology, Brain Cognition and Brain Disease Institute; Shenzhen Fundamental Research Institutions, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen, Guangdong, China
- Harvard Medical School, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Ji Leng
- Chinese Academy of Sciences, Shenzhen Institute of Advanced Technology, Brain Cognition and Brain Disease Institute; Shenzhen Fundamental Research Institutions, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen, Guangdong, China
| | - Ikbal Şencan-Eğilmez
- Harvard Medical School, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Hajime Takase
- Harvard Medical School, Massachusetts General Hospital, Department of Radiology, Charlestown, Massachusetts, United States
- Harvard Medical School, Massachusetts General Hospital, Department of Neurology, Charlestown, Massachusetts, United States
| | - Mohammed Ali H. Alfadhel
- Harvard Medical School, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Buyin Fu
- Harvard Medical School, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Mahnaz Shahidi
- University of Southern California, Department of Ophthalmology, Los Angeles, California, United States
| | - Eng H. Lo
- Harvard Medical School, Massachusetts General Hospital, Department of Radiology, Charlestown, Massachusetts, United States
- Harvard Medical School, Massachusetts General Hospital, Department of Neurology, Charlestown, Massachusetts, United States
| | - Ken Arai
- Harvard Medical School, Massachusetts General Hospital, Department of Radiology, Charlestown, Massachusetts, United States
- Harvard Medical School, Massachusetts General Hospital, Department of Neurology, Charlestown, Massachusetts, United States
| | - Sava Sakadžić
- Harvard Medical School, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
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