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Nesper PL, Fawzi AA. Perfusion Deficits in Diabetes Without Retinopathy Localize to the Perivenular Deep Capillaries Near the Fovea on OCT Angiography. OPHTHALMOLOGY SCIENCE 2024; 4:100482. [PMID: 38751454 PMCID: PMC11090878 DOI: 10.1016/j.xops.2024.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/07/2024] [Accepted: 01/26/2024] [Indexed: 05/18/2024]
Abstract
Purpose To localize early capillary perfusion deficits in patients with diabetes mellitus (DM) without clinical diabetic retinopathy (DR) using averaged OCT angiography (OCTA). Design Retrospective cross-sectional study. Participants Patients with DM without DR and healthy controls. Methods We measured perfusion deficits in the full retina, superficial capillary plexus (SCP), and deep capillary plexus (DCP) on averaged 3 × 3-mm OCTA images. Perfusion deficits were defined as the percentage of retinal tissue located >30 μm from blood vessels, excluding the foveal avascular zone (FAZ). One eye from each patient was selected based on image quality. We measured deficits in the parafoveal region, the 300 μm surrounding the FAZ, and 300 to 1000 μm surrounding the FAZ. If a capillary layer within one of these regions was significantly different in DM without DR compared with controls, we further characterized the location of perfusion deficit as periarteriolar, perivenular, or the capillaries between these 2 zones. Main Outcome Measures Location of increased perfusion deficits in patients with DM without DR compared with controls. Results Sixteen eyes from 16 healthy controls were compared with 16 eyes from 16 patients with DM without DR (age 45.1 ± 10.7 and 47.4 ± 15.2 years respectively, P = 0.64). Foveal avascular zone area and perfusion deficits in the entire parafovea and the 300 to 1000-μm ring around the FAZ were not significantly different between groups (P > 0.05 for all). Perfusion deficits in 300 μm around the FAZ were significantly increased in patients with DM without DR in full retinal thickness, SCP, and DCP (P < 0.05 for all). When analyzing the perivenular, periarteriolar, and capillary zones, only the perivenular DCP perfusion deficits were significantly increased (5.03 ± 2.92% in DM without DR and 2.73 ± 1.97% in controls, P = 0.014). Conclusions Macular perfusion deficits in patients with DM without DR were significantly increased in the region nearest the FAZ, mainly at the perivenular deep capillaries. Further research on these early changes may improve our understanding of the capillaries most susceptible to vascular injury and disruption during diabetes. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Peter L. Nesper
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amani A. Fawzi
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Genç G, Yanık Ö, Demirel S, Batioglu F, Özmert E. The longitudinal follow-up of a newly proposed OCTA imaging finding (SSPiM) and the importance of it as a new biomarker for treatment response in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2024; 262:2491-2502. [PMID: 38530451 PMCID: PMC11271326 DOI: 10.1007/s00417-024-06457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/11/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
PURPOSE This study aimed to evaluate the frequency of SSPiM (suspended scattering particles in motion), systemic risk factors, ocular findings, progression characteristics, and treatment response in diabetic retinopathy (DR) patients. METHODS In this prospective study, a total of 109 eyes of 109 patients with diabetic macular edema (DME) were included. Demographic characteristics and systemic data of the patients were recorded. In addition to a detailed ophthalmological examination, optical coherence tomography (OCT) and OCT angiography (OCTA) imaging were performed. According to the OCTA images, the patients were divided into two categories: SSPiM detected (SSPiM +) and undetected (SSPiM -). The patients were followed up at 0, 3, and 6 months. Treatment responses at 6 months in treatment-administered patients with and without SSPiM were examined. RESULTS The frequency of SSPiM in DME cases was found to be 34.9%. No significant correlation was found between SSPiM and demographic characteristics, systemic, and biochemical parameters (p > 0.05). It was observed that SSPIM was most frequently localized in the outer nuclear layer adjacent to the outer plexiform (81.6%). SSPiM appearance disappeared in 7 (19.4%) of 36 patients with SSPiM who had regular follow-up for 6 months. In 4 (11.1%) of these seven patients, hard exudate plaques developed in the areas where SSPiM disappeared. Regarding treatment response at 6 months, the decrease in CMT was statistically significantly lower in the SSPiM group compared to cases without SSPiM. CONCLUSION SSPiM is a finding seen in approximately one-third of DME patients and may adversely affect the response to the treatment.
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Affiliation(s)
- Gülsüm Genç
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özge Yanık
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sibel Demirel
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.
| | - Figen Batioglu
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emin Özmert
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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Nishida T, Moghimi S, Walker E, Gunasegaran G, Wu JH, Kamalipour A, Mahmoudinezhad G, Zangwill LM, Weinreb RN. Association of foveal avascular zone change and glaucoma progression. Br J Ophthalmol 2024; 108:1101-1106. [PMID: 38164585 PMCID: PMC11192860 DOI: 10.1136/bjo-2023-323970] [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: 10/16/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND/AIMS To investigate the association between longitudinal changes of foveal avascular zone (FAZ) area and the rate of structural and functional progression in glaucoma. METHODS A longitudinal cohort included 115 eyes (46 glaucoma suspect and 66 primary open-angle glaucoma) of 81 patients having ≥2 year follow-up, and ≥4 visits with optical coherence tomography angiography and visual field (VF). Eyes in the longitudinal cohort with a slope greater than that found in 95 percentile of separate healthy test-retest series for FAZ area were categorised into FAZ progressors; all other eyes were defined as FAZ non-progressors. A generalised linear mixed-effect model was used to investigate the association of FAZ progressors with demographic and clinical characteristics. RESULTS Faster ganglion cell complex (GCC) thinning and faster VF mean deviation (MD) loss were found in eyes with FAZ progressors compared with FAZ non-progressors (mean difference: -0.7 (95% CI, -1.4 to -0.1) µm/y; p=0.026, -0.3 (-0.5 to -0.1) dB/y; p=0.017, respectively), while whole image vessel density was not associated with FAZ progressors (p=0.929). SD of intraocular pressure (IOP) and IOP range were also associated with FAZ progressors in separate multivariable models (OR: 1.54 (1.02 to 2.32) per 1 mm Hg higher, p=0.041; OR: 1.20 (1.01 to 1.41) per 1 mm Hg higher; p=0.035, respectively). CONCLUSIONS Significant FAZ increase was weakly associated with moderately faster rates of both GCC thinning and VF MD loss, but not macular vessel density change in glaucoma eyes. Additional studies are needed to elucidate the pathophysiological associations between macula GCC thinning and FAZ area increases in glaucoma.
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Affiliation(s)
- Takashi Nishida
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Sasan Moghimi
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Evan Walker
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Gopikasree Gunasegaran
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Jo-Hsuan Wu
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Alireza Kamalipour
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Golnoush Mahmoudinezhad
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Linda M Zangwill
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
| | - Robert N Weinreb
- University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA
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Lee JS, Bae HW, Kim CY, Lee SY. Systemic Arterial Stiffness and Choroidal Microvascular Insufficiency on the Structural Progression of Normal Tension Glaucoma. Am J Ophthalmol 2024:S0002-9394(24)00293-9. [PMID: 38977152 DOI: 10.1016/j.ajo.2024.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE To identify the role of systemic arterial stiffness and choroidal microvascular insufficiency on structural progression of normal-tension glaucoma (NTG). DESIGN Retrospective cohort study. METHODS A total of 107 early NTG eyes of 88 patients, who underwent pulse wave velocity (PWV) measurements and optical coherence tomography (OCT) angiography (OCT-A) at baseline, were categorized depending on the presence of peripapillary choroidal microvasculature dropout (MvD) and PWV. Differences in glaucomatous progression were analyzed. Structural progression rates were determined using the trend-based analysis of cirrus OCT. RESULTS Thirty-two eyes displayed choroidal MvD (62.7 (95% CI 58.4-67.0) years old, 53.6% males), and 70 eyes did not show any MvD (59.9 (95% CI 57.1-62.6) years old, 53.3% males) at baseline. Patients were followed for 48.4 (95% CI 40.0-56.8) months. When they were further divided based on PWV (high PWV≥1400cm/sec), those with choroidal MvD and high PWV showed significantly faster thinning in macular ganglion cell-inner plexiform layer (GCIPL; P=0.023). In comparison to those with low PWV and no MvD, eyes with high PWV and MvD in the peripapillary area were likely to show fast structural progression (≤-1.2 µm/year) in the macular GCIPL by odds of 6.019 (95% CI 1.619-38.531, P=0.025). CONCLUSIONS In NTG eyes, GCIPL thinning was faster when choroidal MvD and high systemic arterial stiffness were present. The simultaneous presence of regional and systemic vascular insufficiency may be associated with rapid glaucoma structural progression in eyes with low baseline intraocular pressure.
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Affiliation(s)
- Jihei Sara Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyoung Won Bae
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chan Yun Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Yeop Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-Si, Republic of Korea.
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Cennamo G, Rinaldi M, Severino A, De Fazio L, Malvone E, Martinelli V, Costagliola C. Optical coherence tomography angiography features in Waldenström macroglobulinemia patients without Hyperviscosity syndrome: A pilot prospective study. Photodiagnosis Photodyn Ther 2024; 48:104264. [PMID: 38971525 DOI: 10.1016/j.pdpdt.2024.104264] [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: 05/24/2024] [Revised: 06/18/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
PURPOSE To evaluate the retinal vessel density (VD) with optical coherence tomography angiography (OCTA) in asymptomatic patients affected by Waldenström macroglobulinemia (WM) without hyperviscosity syndrome (HVS) and to highlight the presence of microvascular damage in theese clinically asymptomatic WD patients. DESIGN Prospective study. METHODS A total of 43 eyes from 43 WM patients (24 females, 19 males, mean age 55.1 ± 13.6 years) were enrolled from January 2023 to December 2023 in the Eye Clinic of the University of Naples Federico II. Along with WM patients, 40 healthy subjects (HS) (20 females, 20 males, mean age 52.3 ± 15.6 years) with a normal ophthalmic examination and no history of intraocular surgery or retinal pathologic features were included as control group All patients and controls underwent OCTA RESULTS: The two groups were not significantly different for age and sex Visual acuity examination showed no statistically significant difference in BCVA between controls and patients Compared to HS, WD patients showed lower VD values in the SCP in the whole image (47.95 ± 5.17% vs. 52.99 ± 2.52 %; p < 0.001), as well as in the parafovea (53.01 ± 6.69% vs. 55.30 ± 2.61 %; p = 0.002), and fovea (21.38 ± 9.01% vs. 30.31 ± 5.84 %; p < 0.0001). On the other hand, in the DCP VD values were significantly higher in patients compared to controls in the whole image (55.82 ± 8.07% vs. 50.83 ± 5.46 %; p = 0.005), as well as in the parafovea (56.76 ± 6.26% vs. 52.59 ± 5.46 %; p = 0.0001), and fovea (38.75 ± 8.59% vs. 33.43 ± 8.68 %; p < 0.0001). CONCLUSION The finding that OCTA confirmed the presence of widespread microvascular damage in WD patients clinically silent. Thus, OCTA is a safe rapid imaging technique that could represent a valid biomarker of systemic vascular dysfunction.
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Affiliation(s)
- Gilda Cennamo
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy.
| | - Michele Rinaldi
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Alessandro Severino
- Hematology Unit, Department of Clinical medicine and Surgery. University of Naples Federico II, Naples, Italy
| | - Laura De Fazio
- Hematology Unit, Department of Clinical medicine and Surgery. University of Naples Federico II, Naples, Italy
| | - Emanuele Malvone
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Vincenzo Martinelli
- Hematology Unit, Department of Clinical medicine and Surgery. University of Naples Federico II, Naples, Italy
| | - Ciro Costagliola
- Eye Clinic, Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Zhao X, Liu W, Hu Z, Duan L, Zhang X, Li F, Hong B. Rapid prototyping of a retinal multivascular network phantom for optical retinal vascular imaging equipment evaluation. BIOMEDICAL OPTICS EXPRESS 2024; 15:4253-4263. [PMID: 39022546 PMCID: PMC11249693 DOI: 10.1364/boe.523115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/12/2024] [Accepted: 05/30/2024] [Indexed: 07/20/2024]
Abstract
Retinal vascular health holds paramount importance for healthy vision. Many technologies have been developed to examine retinal vasculature non-destructively, including fundus cameras, optical coherence tomography angiography (OCTA), fluorescein angiography (FA), and so on. However, there is a lack of a proper phantom simulating the critical features of the real human retina to calibrate and evaluate the performance of these technologies. In this work, we present a rapid, high-resolution, and economical technology based on 3D printed mold-based soft lithography and spin coating for the fabrication of a multivascular network and multilayer structural retinal phantom with the appropriate optical properties. The feasibility of the retinal phantom as a test device was demonstrated with an OCTA system and a confocal retinal ophthalmoscope. Experiment results prove that the retinal phantom could provide an objective evaluation of the OCTA and confocal retinal ophthalmoscope. Furthermore, the microfluidic phantoms enabled by this fabrication technology may support the development and evaluation of other techniques.
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Affiliation(s)
- Xiaowei Zhao
- Center for Medical Metrology, National Institute of Metrology, 18 North 3rd Ring East Rd., Chaoyang, Beijing 100029, China
| | - Wenli Liu
- Center for Medical Metrology, National Institute of Metrology, 18 North 3rd Ring East Rd., Chaoyang, Beijing 100029, China
| | - Zhixiong Hu
- Center for Medical Metrology, National Institute of Metrology, 18 North 3rd Ring East Rd., Chaoyang, Beijing 100029, China
| | - Liangcheng Duan
- Center for Medical Metrology, National Institute of Metrology, 18 North 3rd Ring East Rd., Chaoyang, Beijing 100029, China
| | - Xiao Zhang
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Fei Li
- Center for Medical Metrology, National Institute of Metrology, 18 North 3rd Ring East Rd., Chaoyang, Beijing 100029, China
| | - Baoyu Hong
- Center for Medical Metrology, National Institute of Metrology, 18 North 3rd Ring East Rd., Chaoyang, Beijing 100029, China
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Oldenburg AL, Ji P, Yu X, Yang L. Compressed intracellular motility via non-uniform temporal sampling in dynamic optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2024; 29:076002. [PMID: 38966847 PMCID: PMC11223688 DOI: 10.1117/1.jbo.29.7.076002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
Significance Optical coherence tomography has great utility for capturing dynamic processes, but such applications are particularly data-intensive. Samples such as biological tissues exhibit temporal features at varying time scales, which makes data reduction challenging. Aim We propose a method for capturing short- and long-term correlations of a sample in a compressed way using non-uniform temporal sampling to reduce scan time and memory overhead. Approach The proposed method separates the relative contributions of white noise, fluctuating features, and stationary features. The method is demonstrated on mammary epithelial cell spheroids in three-dimensional culture for capturing intracellular motility without loss of signal integrity. Results Results show that the spatial patterns of motility are preserved and that hypothesis tests of spheroids treated with blebbistatin, a motor protein inhibitor, are unchanged with up to eightfold compression. Conclusions The ability to measure short- and long-term correlations compressively will enable new applications in (3+1)D imaging and high-throughput screening.
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Affiliation(s)
- Amy L. Oldenburg
- University of North Carolina at Chapel Hill, Department of Physics and Astronomy, Chapel Hill, North Carolina, United States
- University of North Carolina at Chapel Hill, Biomedical Research Imaging Center, Chapel Hill, North Carolina, United States
| | - Pan Ji
- University of North Carolina at Chapel Hill, Department of Physics and Astronomy, Chapel Hill, North Carolina, United States
| | - Xiao Yu
- University of North Carolina at Chapel Hill, Biomedical Research Imaging Center, Chapel Hill, North Carolina, United States
| | - Lin Yang
- University of North Carolina at Chapel Hill, Department of Physics and Astronomy, Chapel Hill, North Carolina, United States
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Çavdarlı C, Büyükyılmaz G, Çavdarlı B, Çomçalı S, Topçu Yılmaz P, Alp MN. Comparison of the optical coherence tomography-angiography (OCT-A) vascular measurements between molecularly confirmed MODY and age-matched healthy controls. Acta Diabetol 2024; 61:917-924. [PMID: 38565685 DOI: 10.1007/s00592-024-02273-6] [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: 09/13/2023] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
AIMS Previous structural, vascular density, and perfusion studies have mostly comprised type 1 and type 2 diabetes, even in the absence of retinopathy. The current study aimed to compare macular vessel density (VD) measurements between maturity-onset diabetes of the young (MODY) patients and controls. METHODS The macular VD of superficial, deep retina, and choriocapillaris (CC), and central macular thickness (CMT), foveal avascular zone (FAZ), FAZ perimetry, VD of the total retina at 300 µm around the FAZ (FD), and acirculatory index (AI) measurements were taken and analyzed via OCT-A (RTVue XR 100-2 Avanti, AngioVue) and were compared between molecularly confirmed MODY (glucokinase (GCK) variants) patients and healthy controls. RESULTS Twenty-five MODY patients and 30 healthy controls were included in the study. The mean plasma hemoglobin A1c level in the MODY group was 6.39 ± 0.38. The mean age was 13.8 ± 2.1 in the MODY group and was 12.6 ± 2.5 years among controls. There was no significant difference in terms of the age, superficial and deep retinal VD, FAZ, FAZ perimetry, CMT, FD, or AI between the groups. Compared to the healthy controls, a slight but significant increase in the CC-VD was detected in the MODY group, but only in the parafoveal and perifoveal regions (p = 0.034, p = 0.009). CONCLUSION The significant CC-VD increase in the MODY group might be associated with hyperglycemia and/or relatively poor and vulnerable peripheral vascular CC perfusion compared to the central. Previous thickness and VD results of childhood or adolescent diabetes were distributed in a wider range, suggesting that various factors, including some not yet clearly defined, may affect the choroidal vasculature independently of glycemia or as a contributing factor.
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Affiliation(s)
- Cemal Çavdarlı
- Department of Ophthalmology, Ankara City Hospital, Bilkent, Ankara, 06800, Turkey.
| | - Gönül Büyükyılmaz
- Department of Pediatric Endocrinology, Ankara City Hospital, Bilkent, Ankara, 06800, Turkey
| | - Büşranur Çavdarlı
- Department of Medical Genetics, Ankara City Hospital, Bilkent, Ankara, 06800, Turkey
| | - Sebile Çomçalı
- Department of Ophthalmology, Ankara City Hospital, Bilkent, Ankara, 06800, Turkey
| | | | - Mehmet Numan Alp
- Department of Ophthalmology, Ankara City Hospital, Health Sciences University, Bilkent, Ankara, 06800, Turkey
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Liu TYA, Mopuru R, Wang M, Arevalo JF, Thorne JE. Swept Source Optical Coherence Tomography Angiography Findings in Birdshot Chorioretinitis: A Cross Sectional Study of 21 Patients. Ocul Immunol Inflamm 2024; 32:616-620. [PMID: 36827643 DOI: 10.1080/09273948.2023.2183412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE Birdshot chorioretinitis (BSCR) is a form of posterior uveitis that is classically characterized by hypopigmented choroidal lesions outside of the major arcades. However, little is known about the extent of choroidal involvement in the macula. We aim to describe the vascular abnormalities observed at the level of the choriocapillaris (CC) in the maculae of BSCR patients, using swept source optical coherence tomography angiography (SS-OCTA). METHODS A cross-sectional, observational study was conducted. Eligible patients underwent clinical examination and SS-OCTA imaging. The main outcome measures were the frequency of vascular abnormalities observed at the level of the CC on SS-OCTA and foveal choriocapillaris vascular density (CVD). RESULTS Twenty-one patients were included, with a median age of 61.5 years. All patients had bilateral disease with a median disease duration of 6 years. All but one patient received systemic immunosuppressive drug therapy, and 19 patients had suppressed inflammation on treatment at the time of the SS-OCTA assessment. Of the 42 affected eyes, 39 (92.9%) had gradable SS-OCTA images, with a mean LogMAR visual acuity of 0.18 (Snellen equivalent 20/30). In total, 34 of 39 (87.2%) eyes had some degree of pathologic flow loss, and after controlling for patient age and disease activity, both worse VA and longer disease duration remained statistically significantly associated with reduced foveal CVD. CONCLUSIONS Our findings suggest that pathologic CC flow loss in the macula is frequently encountered and may contribute to visual function decline in patients with BSCR. Further studies with longitudinal follow-up are needed to characterize the evolution of these areas of pathologic CC flow loss over time.
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Affiliation(s)
- T Y Alvin Liu
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Renuka Mopuru
- Division of Ocular Immunology and Uveitis, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Moying Wang
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - J Fernando Arevalo
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer E Thorne
- Division of Ocular Immunology and Uveitis, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Clinical Trials and Data Synthesis, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Li ZY, Kang M, Qian XZ, Peng R, Hong Q, Ying P, Huang H, Wang XY, Zeng YM, Hu JY, Chen X, Wu R, Shao Y, Yu SJ. Retinal thickness and microvascular alterations observed by optical coherence tomography in antineutrophil cytoplasmic antibody-associated vasculitis: a cross-sectional study. Quant Imaging Med Surg 2024; 14:4998-5011. [PMID: 39022287 PMCID: PMC11250291 DOI: 10.21037/qims-23-1717] [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: 12/04/2023] [Accepted: 05/22/2024] [Indexed: 07/20/2024]
Abstract
Background As an autoimmune disease, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) often affects multiple organs, including the ocular system. This study aims to investigate differences in retinal thickness (RT) and retinal superficial vascular density (SVD) between patients with AAV and healthy controls (HCs) using optical coherence tomography angiography (OCTA). Currently, these differences are not clear. Methods A total of 16 AAV individuals (32 eyes) and 16 HCs (32 eyes) were recruited to this cross-sectional study conducted in the First Affiliated Hospital of Nanchang University from June 2023 to September 2023. The study protocol conformed with the tenets of the Declaration of Helsinki (as revised in 2013). Each image observed by OCTA was divided into 9 regions using the Early Treatment Diabetic Retinopathy Study (ETDRS) subzones as a guide. Results In the full layer, the RT of AAV patients was found to be significantly reduced in the inner superior (IS, P<0.001), outer superior (OS, P=0.003), inner temporal (IT, P=0.003), and outer temporal (OT, P<0.001) regions; inner RT was significantly lower in the IS (P=0.006), OS (P<0.001), inner nasal (IN, P=0.005), outer nasal (ON, P<0.001), and center (C, P=0.01) regions than that in HCs. Outer RT of AAV patients showed a reduction in the IS (P<0.001), as well as IT (P=0.008), and OT (P<0.001) regions. No statistically significant differences were seen in the different subregions in other different layers (P>0.05). Only the inner inferior (II) and outer inferior (OI) regions of SVD in AAV patients did not differ significantly from controls. All other regions showed a reduction in SVD. The details are as follows: IS (P<0.001), OS (P<0.001), IT (P=0.005), OT (P<0.001), IN (P<0.001), ON (P<0.001), and C (P=0.003). According to receiver operating characteristic (ROC) curve analysis, the full IS region [area under the curve (AUC): 0.8892, 95% confidence interval (CI): 0.8041-0.9742, P<0.001] had the highest diagnostic value for AAV-induced reduction in RT. The IS (AUC: 0.9121, 95% CI: 0.8322-0.9920, P<0.001) region was also the most sensitive to changes in SVD of AAV individuals. In addition, we found that SVD in the IN region (r=-0.4224, 95% CI: -0.6779 to -0.0757, P=0.02) as well as mean visual acuity (r=-0.3922, 95% CI: -0.6579 to -0.0397, P=0.03) of AAV patients were negatively correlated with disease duration. However, we did not find an association between SVD and RT in this study. Conclusions The findings from OCTA indicated a reduction in RT and SVD among patients with AAV. OCTA allows for the evaluation of AAV-related ocular lesions and holds promise for monitoring of disease progression through regular evaluations.
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Affiliation(s)
- Zi-Yuan Li
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xian-Zhe Qian
- Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Rui Peng
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Qi Hong
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Ping Ying
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Hui Huang
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xiao-Yu Wang
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yan-Mei Zeng
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Jin-Yu Hu
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xu Chen
- Ophthalmology Centre of Maastricht University, Maastricht, The Netherlands
| | - Rui Wu
- Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Shu-Jiao Yu
- Department of Rheumatology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
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11
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Zhu Y, Zhu L, Lim Y, Makita S, Guo Y, Yasuno Y. Multiple scattering suppression for in vivo optical coherence tomography measurement using the B-scan-wise multi-focus averaging method. BIOMEDICAL OPTICS EXPRESS 2024; 15:4044-4064. [PMID: 39022550 PMCID: PMC11249682 DOI: 10.1364/boe.524894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/20/2024]
Abstract
We demonstrate a method that reduces the noise caused by multi-scattering (MS) photons in an in vivo optical coherence tomography image. This method combines a specially designed image acquisition (i.e., optical coherence tomography scan) scheme and subsequent complex signal processing. For the acquisition, multiple cross-sectional images (frames) are sequentially acquired while the depth position of the focus is altered for each frame by an electrically tunable lens. In the signal processing, the frames are numerically defocus-corrected, and complex averaged. Because of the inconsistency in the MS-photon trajectories among the different electrically tunable lens-induced defocus, this averaging reduces the MS signal. Unlike the previously demonstrated volume-wise multi-focus averaging method, our approach requires the sample to remain stable for only a brief period, approximately 70 ms, thus making it compatible with in vivo imaging. This method was validated using a scattering phantom and in vivo unanesthetized small fish samples, and was found to reduce MS noise even for unanesthetized in vivo measurement.
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Affiliation(s)
- Yiqiang Zhu
- Computational Optics Group, University of Tsukuba
, Tsukuba, Ibaraki, Japan
| | - Lida Zhu
- Computational Optics Group, University of Tsukuba
, Tsukuba, Ibaraki, Japan
| | - Yiheng Lim
- Computational Optics Group, University of Tsukuba
, Tsukuba, Ibaraki, Japan
| | - Shuichi Makita
- Computational Optics Group, University of Tsukuba
, Tsukuba, Ibaraki, Japan
| | - Yu Guo
- Computational Optics Group, University of Tsukuba
, Tsukuba, Ibaraki, Japan
| | - Yoshiaki Yasuno
- Computational Optics Group, University of Tsukuba
, Tsukuba, Ibaraki, Japan
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12
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Savastano MC, Nociti V, Giannuzzi F, Cestrone V, Carlà MM, Fossataro C, Biagini I, Rizzo C, Kilian R, Bisurgi M, Calabresi P, Mirabella M, Rizzo S. Optical Coherence Tomography Advanced Parameters in Patients With Multiple Sclerosis: Ophthalmological and Neurological Assessments. Am J Ophthalmol 2024; 267:41-49. [PMID: 38901720 DOI: 10.1016/j.ajo.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE To evaluate ophthalmological, neurological, radiological, and laboratory data in patients with multiple sclerosis (MS) and to identify new ophthalmological factors that could be helpful as biomarkers of the disease, potentially leading to an earlier prediction of disease course and disability progression. DESIGN Retrospective, cross-sectional-study. METHODS Best-corrected visual acuity (BCVA), ophthalmological biomicroscopy of the anterior segment and fundus, structural optical coherence tomography (OCT) with retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), and OCT angiography (OCTA) with vascular density (VD) were performed. The following clinical and neuro-radiological features were assessed: MS phenotype, disease duration, clinical severity, type of treatment, and T2-weighted lesion and T1-weighted Gd+ enhancing lesion number on the brain and spinal cord MRI. RESULTS One hundred and six patients (212 eyes) were analyzed. Sixty-six of them (62.2%) had MS and 40 (37.8%) were matched healthy controls (HCs). patients with MS showed lower RNFL, GCC, and VD in the radial peripapillary capillary plexus than controls in both eyes (P < .05). By Performing a logistic regression with a distinct MS outcome for both eyes, we were able to demonstrate that the value that was most predictive of MS was the average GCC thickness (P = .009). Regression analysis demonstrated that patients with a higher T2-weighted lesions showed a lower RNFL thickness value and reduced GCC and VD values than those with a low lesion load (P < .01 and P < .05, respectively). Similarly, relapsing MS patients showed lower RNFL values (P < .05). CONCLUSIONS Several OCT and OCTA-optic nerve parameters could be useful prognostic biomarkers for the MS disease course in clinical practice. However, it is necessary to do additional research with larger sample sizes in order to validate these findings.
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Affiliation(s)
- Maria Cristina Savastano
- From the Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS (M.C.S., F.G., V.C., M.M.C., C.F., S.R.), Rome, Italy; Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy
| | - Viviana Nociti
- Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy; Centro di Ricerca Sclerosi Multipla (CERSM), Università Cattolica (V.N., M.B., M.M.), Rome, Italy
| | - Federico Giannuzzi
- From the Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS (M.C.S., F.G., V.C., M.M.C., C.F., S.R.), Rome, Italy; Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy.
| | - Valentina Cestrone
- From the Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS (M.C.S., F.G., V.C., M.M.C., C.F., S.R.), Rome, Italy; Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy
| | - Matteo Mario Carlà
- From the Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS (M.C.S., F.G., V.C., M.M.C., C.F., S.R.), Rome, Italy; Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy
| | - Claudia Fossataro
- From the Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS (M.C.S., F.G., V.C., M.M.C., C.F., S.R.), Rome, Italy; Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy
| | - Ilaria Biagini
- Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy; Department NEUROFARBA, University of Florence (I.B.), Florence, Italy
| | - Clara Rizzo
- Ophthalmology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa (C.R.), Pisa, Italy; Ophthalmology Unit, University of Verona (C.R., R.K.), Verona, Italy
| | - Raphael Kilian
- Ophthalmology Unit, University of Verona (C.R., R.K.), Verona, Italy
| | - Marco Bisurgi
- Centro di Ricerca Sclerosi Multipla (CERSM), Università Cattolica (V.N., M.B., M.M.), Rome, Italy; UOC Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS (M.B., P.C., M.M.), Rome, Italy
| | - Paolo Calabresi
- UOC Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS (M.B., P.C., M.M.), Rome, Italy
| | - Massimiliano Mirabella
- Centro di Ricerca Sclerosi Multipla (CERSM), Università Cattolica (V.N., M.B., M.M.), Rome, Italy; UOC Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS (M.B., P.C., M.M.), Rome, Italy
| | - Stanislao Rizzo
- From the Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS (M.C.S., F.G., V.C., M.M.C., C.F., S.R.), Rome, Italy; Catholic University of the Sacred Heart (M.C.S., V.N., F.G., V.C., M.M.C., C.F., I.B., S.R.), Rome, Italy; Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze (S.R.), Pisa, Italy
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13
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Torm MEW, Pircher M, Bonnin S, Johannesen J, Klefter ON, Schmidt MF, Frederiksen JL, Lefaudeux N, Andilla J, Valdes C, Loza-Alvarez P, Brea LS, De Jesus DA, Grieve K, Paques M, Larsen M, Gocho K. Detection of capillary abnormalities in early diabetic retinopathy using scanning laser ophthalmoscopy and optical coherence tomography combined with adaptive optics. Sci Rep 2024; 14:13450. [PMID: 38862584 PMCID: PMC11166634 DOI: 10.1038/s41598-024-63749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024] Open
Abstract
This study tested if a high-resolution, multi-modal, multi-scale retinal imaging instrument can provide novel information about structural abnormalities in vivo. The study examined 11 patients with very mild to moderate non-proliferative diabetic retinopathy (NPDR) and 10 healthy subjects using fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), adaptive optics scanning laser ophthalmoscopy (AO-SLO), adaptive optics OCT and OCTA (AO-OCT(A)). Of 21 eyes of 11 patients, 11 had very mild NPDR, 8 had mild NPDR, 2 had moderate NPDR, and 1 had no retinopathy. Using AO-SLO, capillary looping, inflections and dilations were detected in 8 patients with very mild or mild NPDR, and microaneurysms containing hyperreflective granular elements were visible in 9 patients with mild or moderate NPDR. Most of the abnormalities were seen to be perfused in the corresponding OCTA scans while a few capillary loops appeared to be occluded or perfused at a non-detectable flow rate, possibly because of hypoperfusion. In one patient with moderate NPDR, non-perfused capillaries, also called ghost vessels, were identified by alignment of corresponding en face AO-OCT and AO-OCTA images. The combination of multiple non-invasive imaging methods could identify prominent microscopic abnormalities in diabetic retinopathy earlier and more detailed than conventional fundus imaging devices.
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Affiliation(s)
- Marie Elise Wistrup Torm
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark.
| | - Michael Pircher
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Sophie Bonnin
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
- Foundation Rothschild Hospital, 25-29, Rue Manin, 75019, Paris, France
| | - Jesper Johannesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Pediatrics, Herlev-Gentofte Hospital, Borgmester Ib Juuls Vej 25C, Herlev, Denmark
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Oliver Niels Klefter
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - Mathias Falck Schmidt
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Neurology, Clinic of Optic Neuritis, The Danish Multiple Sclerosis Center (DMSC), Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark
| | - Jette Lautrup Frederiksen
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
- Department of Neurology, Clinic of Optic Neuritis, The Danish Multiple Sclerosis Center (DMSC), Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark
| | | | - Jordi Andilla
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Claudia Valdes
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Pablo Loza-Alvarez
- The Barcelona Institute of Science and Technology, ICFO-Institut de Ciencies Fotoniques, 08860, Castelldefels, Barcelona, Spain
| | - Luisa Sanchez Brea
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, The Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, The Netherlands
| | - Danilo Andrade De Jesus
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, The Rotterdam Ophthalmic Institute, Schiedamse Vest 160, Rotterdam, The Netherlands
| | - Kate Grieve
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
| | - Michel Paques
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
| | - Michael Larsen
- Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - Kiyoko Gocho
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
- INSERM, CNRS, Institut de La Vision, Sorbonne Université, 17 Rue Moreau, 75012, Paris, France
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14
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Nishida T, Moghimi S, Gunasegaran G, Walker E, Wu JH, Rahmatnejad K, Zangwill LM, Baxter SL, Weinreb RN. Association between metformin use with circumpapillary retinal nerve fibre layer thickness and capillary vessel density in glaucoma. Br J Ophthalmol 2024:bjo-2023-325035. [PMID: 38839252 DOI: 10.1136/bjo-2023-325035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND/AIMS To investigate the association between use of metformin and circumpapillary retinal nerve fibre layer (cpRNFL) thickness, as well as whole image capillary density (wiCD), in patients with glaucoma. METHODS This cross-sectional study included patients with glaucoma suspect or primary open-angle glaucoma (POAG) underwent optical coherence tomography angiography imaging. Use and duration of antidiabetic medications were assessed at the time of imaging. Multivariable linear mixed-effect modelling was used to estimate the effect of diabetes medication on wiCD and cpRNFL while controlling for covariates including age, race, body mass index, diagnosis, 24-2 visual field mean deviation, and intraocular pressure, average signal strength index as well as any variables that showed a p <0.1 in the univariable analysis. RESULTS A total of 577 eyes (330 POAG and 247 glaucoma suspect) of 346 patients were included. Sixty-five patients (23%) had diabetes, of whom 55 (78.5%) used metformin, and 17 (26.2%) used insulin. After adjusting for covariates, the association between metformin use and wiCD (1.56 (95% CI 0.40 to 2.71); p=0.008), duration of metformin use and wiCD (0.12 (95% CI 0.02 to 0.22) per 1 year longer; p=0.037), and metformin use and cpRNFL thickness (5.17 (95% CI 1.24 to 9.10) µm; p=0.010) had statistically significant associations in each model. CONCLUSIONS Metformin use was associated with higher wiCD and thicker cpRNFL. These findings indicate a potential association, underscoring the need for longitudinal studies to determine if metformin plays a role in the retinal conditions of patients with glaucoma. TRIAL REGISTRATION NUMBER NCT00221897.
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Affiliation(s)
- Takashi Nishida
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Gopikasree Gunasegaran
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Evan Walker
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jo-Hsuan Wu
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Kamran Rahmatnejad
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Linda M Zangwill
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sally L Baxter
- Division of Ophthalmology Informatics and Data Science and Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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15
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Huang BB, Fawzi AA. Hypertension Likely Drives Arteriolar Wall Thickening in Preclinical Diabetic Retinopathy While Diabetes Drives Wall Thickness in Clinical Retinopathy. Transl Vis Sci Technol 2024; 13:8. [PMID: 38874974 PMCID: PMC11182368 DOI: 10.1167/tvst.13.6.8] [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: 03/03/2024] [Accepted: 05/01/2024] [Indexed: 06/15/2024] Open
Abstract
Purpose Both hypertension and diabetes are known to increase the wall-to-lumen ratio (WLR) of retinal arterioles, but the differential effects are unknown. Here, we study the timing and relative impact of hypertension versus diabetes on the WLR in diabetic retinopathy (DR) to address this unresolved question. Methods This prospective cross-sectional study compared the retinal arteriolar WLR in 17 healthy eyes, 15 with diabetes but no apparent DR (DM no DR), and 8 with diabetic macular edema (DME) and either nonproliferative or proliferative DR. We imaged each arteriole using adaptive optics scanning laser ophthalmoscopy and measured the WLR using ImageJ. Multiple linear regression (MLR) was performed to estimate the effects of hypertension, diabetes, and age on the WLR. Results Both subjects with DM no DR and subjects with DME had significantly higher WLR than healthy subjects (0.36 ± 0.08 and 0.42 ± 0.08 vs. 0.29 ± 0.07, 1-way ANOVA P = 0.0009). MLR in healthy subjects and subjects with DM no DR showed hypertension had the strongest effect (regression coefficient = 0.08, P = 0.009), whereas age and diabetes were not significantly correlated with WLR. MLR in all three groups together (healthy, DM no DR, and DME) showed diabetes had the strongest effect (regression coefficient = 0.05, P = 0.02), whereas age and hypertension were not significantly correlated with WLR. Conclusions Hypertension may be an early driver of retinal arteriolar wall thickening in preclinical DR, independent of age or diabetes, whereas changes specific to DR may drive wall thickening in DME and later DR stages. Translational Relevance We offer a framework for understanding the relative contributions of hypertension and diabetes on the vascular wall, and emphasize the importance of hypertension control early in diabetes even before DR onset.
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Affiliation(s)
- Bonnie B. Huang
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amani A. Fawzi
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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16
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Fayed AE, Menten MJ, Kreitner L, Paetzold JC, Rueckert D, Bassily SM, Fikry RR, Hagag AM, Sivaprasad S. Retinal vasculature of different diameters and plexuses exhibit distinct vulnerability in varying severity of diabetic retinopathy. Eye (Lond) 2024; 38:1762-1769. [PMID: 38514853 PMCID: PMC11156674 DOI: 10.1038/s41433-024-03021-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/08/2024] [Accepted: 03/06/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES To study the changes in vessel densities (VD) stratified by vessel diameter in the retinal superficial and deep vascular complexes (SVC/DVC) using optical coherence tomography angiography (OCTA) images obtained from people with diabetes and age-matched healthy controls. METHODS We quantified the VD based on vessel diameter categorized as <10, 10-20 and >20 μm in the SVC/DVC obtained on 3 × 3 mm2 OCTA scans using a deep learning-based segmentation and vascular graph extraction tool in people with diabetes and age-matched healthy controls. RESULTS OCTA images obtained from 854 eyes of 854 subjects were divided into 5 groups: healthy controls (n = 555); people with diabetes with no diabetic retinopathy (DR, n = 90), mild and moderate non-proliferative DR (NPDR) (n = 96), severe NPDR (n = 42) and proliferative DR (PDR) (n = 71). Both SVC and DVC showed significant decrease in VD with increasing DR severity (p < 0.001). The largest difference was observed in the <10 μm vessels of the SVC between healthy controls and no DR (13.9% lower in no DR, p < 0.001). Progressive decrease in <10 μm vessels of the SVC and DVC was seen with increasing DR severity (p < 0.001). However, 10-20 μm vessels only showed decline in the DVC, but not the SVC (p < 0.001) and there was no change observed in the >20 μm vessels in either plexus. CONCLUSIONS Our findings suggest that OCTA is able to demonstrate a distinct vulnerability of the smallest retinal vessels in both plexuses that worsens with increasing severity of DR.
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Affiliation(s)
- Alaa E Fayed
- Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt.
- Watany Eye Hospital, Cairo, Egypt.
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Martin J Menten
- Lab for AI in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- BioMedIA, Imperial College London, London, UK
| | - Linus Kreitner
- Lab for AI in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Johannes C Paetzold
- Lab for AI in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- BioMedIA, Imperial College London, London, UK
| | - Daniel Rueckert
- Lab for AI in Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- BioMedIA, Imperial College London, London, UK
| | | | - Ramy R Fikry
- Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Giza, Egypt
- Watany Eye Hospital, Cairo, Egypt
| | - Ahmed M Hagag
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Boehringer Ingelheim Limited, London, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- University College London, London, UK
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17
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Fang R, Zhang P, Zhang T, Kim D, Sun E, Kuranov R, Kweon J, Huang A, Zhang HF. Freeform robotic optical coherence tomography beyond the optical field-of-view limit. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.21.595073. [PMID: 38826217 PMCID: PMC11142137 DOI: 10.1101/2024.05.21.595073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Imaging complex, non-planar anatomies with optical coherence tomography (OCT) is limited by the optical field of view (FOV) in a single volumetric acquisition. Combining linear mechanical translation with OCT extends the FOV but suffers from inflexibility in imaging non-planar anatomies. We report the freeform robotic OCT to fill this gap. To address challenges in volumetric reconstruction associated with the robotic movement accuracy being two orders of magnitudes worse than OCT imaging resolution, we developed a volumetric registration algorithm based on simultaneous localization and mapping (SLAM) to overcome this limitation. We imaged the entire aqueous humor outflow pathway, whose imaging has the potential to customize glaucoma surgeries but is typically constrained by the FOV, circumferentially in mice as a test. We acquired volumetric OCT data at different robotic poses and reconstructed the entire anterior segment of the eye. The reconstructed volumes showed heterogeneous Schlemm's canal (SC) morphology in the reconstructed anterior segment and revealed a segmental nature in the circumferential distribution of collector channels (CC) with spatial features as small as a few micrometers.
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18
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Abdolrahimzadeh S, Evangelisti M, Gattazzo I, Arpinelli M, Di Nardo G, Federico DS, Simmaco M, Salerno G, Parisi P, Scuderi G, Villa MP. Oxidative stress and optical coherence tomography angiography evaluation of choriocapillaris and retinal vessel density in children with obstructive sleep apnea. Sleep Breath 2024; 28:639-646. [PMID: 37843681 DOI: 10.1007/s11325-023-02930-0] [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: 08/24/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES To investigate the vascular networks of the retina and choroid using optical coherence tomography angiography (OCTA) to identify early biomarkers of obstructive sleep apnea (OSA) severity and to evaluate correlations with blood levels of oxidative stress. STUDY DESIGN Patients with OSA were diagnosed based on video-polysomnography (PSG) and blood samples were collected to evaluate oxidative stress markers: total antioxidant status (TAS), biological antioxidant potential (BAP) test, Diacron reactive oxygen metabolites (d-ROMs) test. The eyes of children with OSA were evaluated and compared with eyes of healthy age-matched children. OCTA imaging was carried out to evaluate the choroidal and retinal vascular network density indices. RESULTS A total of 31 children with OSA were recruited and compared with 10 healthy children. Choriocapillaris flow area decreased (p = 0.006) and superficial capillary plexus vessel density increased (p=0.01) with increasing severity of OSA. Children with OSA showed significant differences in TAS and d-ROMs test when compared to normal pediatric values (p<0.05). In calculating the correlations between PSG, oxidative stress, and OCTA variables, there was a negative correlation between choriocapillaris flow area and apnea hypopnea index (AHI) (p = 0.02, r2 -0.5) and between choriocapillaris flow area and the d-ROMs test (p 0.03; r2 0.5). CONCLUSIONS The severity of OSA was associated with the choroidal and retinal capillary vascular networks. The correlation of the choriocapillaris flow area with AHI and the d-ROMs test indicates the connection of the choroidal microvasculature with the number of obstructive apnea and hypopnea events and oxidative stress.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
| | - Melania Evangelisti
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
- Paediatrics Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Irene Gattazzo
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Marta Arpinelli
- Paediatrics Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Giovanni Di Nardo
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
- Paediatrics Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Di Staso Federico
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Maurizio Simmaco
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
- Biochemistry & Molecular Biology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Gerardo Salerno
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
- Biochemistry & Molecular Biology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Pasquale Parisi
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
- Paediatrics Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Gianluca Scuderi
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy
| | - Maria Pia Villa
- St. Andrea University Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Rome, Italy.
- Paediatrics Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy.
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Simms AG, Parrino R, Gameiro GR, Cipolla J, Wang J, Jiang H, Signorile JF. Decreased retinal capillary density as a beneficial response to 24-week high-speed circuit resistant training in healthy older adults. Microvasc Res 2024; 153:104668. [PMID: 38325749 PMCID: PMC10960248 DOI: 10.1016/j.mvr.2024.104668] [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: 12/05/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To determine the changes in retinal microvascular density after a 24-week high-speed circuit resistance training program (HSCT) in healthy older adults. METHODS Thirty healthy older adults were recruited and randomly assigned to either a training group (HSCT) or a non-training (CON) group. Fifteen subjects (age 73.3 ± 7.76 yrs) in the HSCT group exercised three times per week on non-consecutive days for 24 weeks. Fifteen subjects in the CON group (age 72.2 ± 6.04 yrs) did not have formal physical training. Both eyes of each subject were imaged using optical coherence tomography angiography (OCTA) at baseline and at the 24-week follow-up. The vessel densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured. RESULTS There were no demographic differences between the study groups. There were significant decreases in the retinal vessel densities of RVN, SVP and DVP in the HSCT group (P < 0.05). However, there were no significant changes in all three vascular measurements in the CON group (P > 0.05), although the changes showed a decreasing trend. The decreased vessel densities were doubled in the HSCT group in comparison to the CON group. However, the differences between groups did not reach a significant level (P > 0.05). CONCLUSIONS This is the first study to reveal the decreased retinal vessel densities as a possible imaging marker for the beneficial effects of the 24-week HSCT program in older adults.
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Affiliation(s)
- Ava-Gaye Simms
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rosalia Parrino
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - Gustavo Rosa Gameiro
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jack Cipolla
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Joseph F Signorile
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA.
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20
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Wang CY, Sadrieh FK, Shen YT, Chen SE, Kim S, Chen V, Raghavendra A, Wang D, Saeedi O, Tao Y. MEMO: dataset and methods for robust multimodal retinal image registration with large or small vessel density differences. BIOMEDICAL OPTICS EXPRESS 2024; 15:3457-3479. [PMID: 38855695 PMCID: PMC11161385 DOI: 10.1364/boe.516481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/20/2024] [Accepted: 04/18/2024] [Indexed: 06/11/2024]
Abstract
The measurement of retinal blood flow (RBF) in capillaries can provide a powerful biomarker for the early diagnosis and treatment of ocular diseases. However, no single modality can determine capillary flowrates with high precision. Combining erythrocyte-mediated angiography (EMA) with optical coherence tomography angiography (OCTA) has the potential to achieve this goal, as EMA can measure the absolute RBF of retinal microvasculature and OCTA can provide the structural images of capillaries. However, multimodal retinal image registration between these two modalities remains largely unexplored. To fill this gap, we establish MEMO, the first public multimodal EMA and OCTA retinal image dataset. A unique challenge in multimodal retinal image registration between these modalities is the relatively large difference in vessel density (VD). To address this challenge, we propose a segmentation-based deep-learning framework (VDD-Reg), which provides robust results despite differences in vessel density. VDD-Reg consists of a vessel segmentation module and a registration module. To train the vessel segmentation module, we further designed a two-stage semi-supervised learning framework (LVD-Seg) combining supervised and unsupervised losses. We demonstrate that VDD-Reg outperforms existing methods quantitatively and qualitatively for cases of both small VD differences (using the CF-FA dataset) and large VD differences (using our MEMO dataset). Moreover, VDD-Reg requires as few as three annotated vessel segmentation masks to maintain its accuracy, demonstrating its feasibility.
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Affiliation(s)
- Chiao-Yi Wang
- Department of Bioengineering, University of Maryland, College Park, MD 20742, USA
| | | | - Yi-Ting Shen
- Department of Electrical and Computer Engineering, University of Maryland, College Park, MD 20742, USA
| | - Shih-En Chen
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Sarah Kim
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Victoria Chen
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Achyut Raghavendra
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Dongyi Wang
- Department of Biological and Agricultural Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Osamah Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Yang Tao
- Department of Bioengineering, University of Maryland, College Park, MD 20742, USA
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21
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Ravichandran S, Snyder PJ, Alber J, Kenny MR, Rothstein A, Brown K, Murchison CF, Clay OJ, Roberson ED, Arthur E. Quantifying Putative Retinal Gliosis in Preclinical Alzheimer's Disease. Invest Ophthalmol Vis Sci 2024; 65:5. [PMID: 38696189 PMCID: PMC11077916 DOI: 10.1167/iovs.65.5.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Purpose Neuroinflammation plays a significant role in the pathology of Alzheimer's disease (AD). Mouse models of AD and postmortem biopsy of patients with AD reveal retinal glial activation comparable to central nervous system immunoreactivity. We hypothesized that the surface area of putative retinal gliosis observed in vivo using en face optical coherence tomography (OCT) imaging will be larger in patients with preclinical AD versus controls. Methods The Spectralis II instrument was used to acquire macular centered 20 × 20 and 30 × 25-degrees spectral domain OCT images of 76 participants (132 eyes). A cohort of 22 patients with preclinical AD (40 eyes, mean age = 69 years, range = 60-80 years) and 20 control participants (32 eyes, mean age = 66 years, range = 58-82 years, P = 0.11) were included for the assessment of difference in surface area of putative retinal gliosis and retinal nerve fiber layer (RNFL) thickness. The surface area of putative retinal gliosis and RNFL thickness for the nine sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) map were compared between groups using generalized linear mixed models. Results The surface area of putative retinal gliosis was significantly greater in the preclinical AD group (0.97 ± 0.55 mm2) compared to controls (0.68 ± 0.40 mm2); F(1,70) = 4.41, P = 0.039; Cohen's d = 0.61. There was no significant difference between groups for RNFL thickness in the 9 ETDRS sectors, P > 0.05. Conclusions Our analysis shows greater putative retinal gliosis in preclinical AD compared to controls. This demonstrates putative retinal gliosis as a potential biomarker for AD-related neuroinflammation.
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Affiliation(s)
- Swetha Ravichandran
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Peter J. Snyder
- Department of Neurology, Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island, United States
| | - Jessica Alber
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, Rhode Island, United States
- Butler Hospital Memory and Aging Program, Providence, Rhode Island, United States
| | - Madelyn R. Kenny
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Andrew Rothstein
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Keisha Brown
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Charles F. Murchison
- Alzheimer's Disease Research Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Olivio J. Clay
- Alzheimer's Disease Research Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Erik D. Roberson
- Alzheimer's Disease Research Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Edmund Arthur
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
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22
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Ni S, Liang GB, Ng R, Ostmo S, Jia Y, Chiang MF, Huang D, Skalet AH, Young BK, Campbell JP, Jian Y. Panretinal handheld OCT angiography for pediatric retinal imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:3412-3424. [PMID: 38855676 PMCID: PMC11161374 DOI: 10.1364/boe.520739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 06/11/2024]
Abstract
Comprehensive visualization of retina morphology is essential in the diagnosis and management of retinal diseases in pediatric populations. Conventional imaging techniques often face challenges in effectively capturing the peripheral retina, primarily due to the limitations in current optical designs, which lack the necessary field of view to characterize the far periphery. To address this gap, our study introduces a novel ultra-widefield optical coherence tomography angiography (OCTA) system. This system, specifically tailored for pediatric applications, incorporates an ultrahigh-speed 800 kHz swept-source laser. The system's innovative design achieves a 140° field of view while maintaining excellent optical performance. Over the last 15 months, we have conducted 379 eye examinations on 96 babies using this system. It demonstrates marked efficacy in the diagnosis of retinopathy of prematurity, providing detailed and comprehensive peripheral retinal angiography. The capabilities of the ultra-widefield handheld OCTA system in enhancing the clarity and thoroughness of retina vascularization assessments have significantly improved the precision of diagnoses and the customization of treatment strategies. Our findings underscore the system's potential to advance pediatric ophthalmology and broaden the scope of retinal imaging.
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Affiliation(s)
- Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Guangru Ben Liang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Ringo Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Susan Ostmo
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Michael F. Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD 20892, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alison H. Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Benjamin K. Young
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - J. Peter Campbell
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
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23
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Chan WCF, Zhu MM, Choy BNK, Chan JCH, Ng ALK, Shih KC, Cheung JJC, Wong JKW, Shum JWH, Ni MY, Lai JSM, Leung GM, Wong IYH. Contribution of systemic factors on macular vessel density: a sex-specific population-based study. Jpn J Ophthalmol 2024; 68:174-182. [PMID: 38658452 DOI: 10.1007/s10384-024-01053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/22/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To evaluate the influence of systemic factors on macular vessel density in quantitative Optical Coherence Tomography Angiography (OCTA) by sex. STUDY DESIGN A cross-sectional study. METHODS A total of 2018 adults were recruited in this study. Participants were excluded (n=964) due to missing data, eye-related problems, or low OCTA scan quality. Macular vessel densities were measured with OCTA using split-spectrum amplitude decorrelation angiography algorithm. Only the data from the right eyes were selected for analysis. Multivariable linear regression analysis was performed to determine the associations between macular vessel density and obesity-related systemic factors in each gender group. RESULTS The right eyes of 1054 participants (59.6% women) were enrolled. Men had significantly higher obesity parameters and associated risk factors. In multivariable linear regression analysis in men, older age and type 2 diabetes mellitus were independently associated with lower superficial retinal vessel density (β = -0.37, p = 0.002; β = -1.22, p = 0.03) and deep retinal vessel density, respectively (β = -0.66, p < 0.001; β = -1.76, p = 0.02); positive association was also observed between body mass index (BMI) and superficial retinal vessel density (β = 0.56, p = 0.02). In women, only higher systolic blood pressure was independently associated with a lower deep retinal vessel density (β = -0.50, p = 0.003). CONCLUSIONS This large cross-sectional study shows that older age and type 2 diabetes mellitus are associated with lower superficial and deep retinal capillary vessel density in men. This may help clinicians better understand how systemic factors influence retinal vessel density in different genders and future studies can ascertain more potential sex differences.
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Affiliation(s)
| | - Ming Ming Zhu
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Bonnie Nga Kwan Choy
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China.
| | - Jonathan Cheuk Hung Chan
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Alex Lap Ki Ng
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Kendrick Co Shih
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Janice Jing Chee Cheung
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Jasper Ka Wai Wong
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Jennifer Wei Huen Shum
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Michael Yuxuan Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
- Healthy High Density Cities Laboratory, HKUrbanLab, The University of Hong Kong, Hong Kong SAR, China
| | - Jimmy Shiu Ming Lai
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
| | - Gabriel Matthew Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian Yat Hin Wong
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong SAR, China
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24
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Braun M, Saini C, Sun JA, Shen LQ. The Role of Optical Coherence Tomography Angiography in Glaucoma. Semin Ophthalmol 2024:1-12. [PMID: 38643350 DOI: 10.1080/08820538.2024.2343049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
Glaucoma is the leading cause of irreversible vision loss and comprises a group of chronic optic neuropathies characterized by progressive retinal ganglion cell (RGC) loss. Various etiologies, including impaired blood supply to the optic nerve, have been implicated for glaucoma pathogenesis. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality for visualizing the ophthalmic microvasculature. Using blood flow as an intrinsic contrast agent, it distinguishes blood vessels from the surrounding tissue. Vessel density (VD) is mainly used as a metric for quantifying the ophthalmic microvasculature. The key anatomic regions for OCTA in glaucoma are the optic nerve head area including the peripapillary region, and the macular region. Specifically, VD of the superficial peripapillary and superficial macular microvasculature is reduced in glaucoma patients compared to unaffected subjects, and VD correlates with functional deficits measured by visual field (VF). This renders OCTA similar in diagnostic capabilities compared to structural retinal nerve fiber layer (RNFL) thickness measurements, especially in early glaucoma. Furthermore, in cases where RNFL thickness measurements are limited due to artifact or floor effect, OCTA technology can be used to evaluate and monitor glaucoma, such as in eyes with high myopia and eyes with advanced glaucoma. However, the clinical utility of OCTA in glaucoma management is limited due to the prevalence of imaging artifacts. Overall, OCTA can play a complementary role in structural OCT imaging and VF testing to aid in the diagnosis and monitoring of glaucoma.
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Affiliation(s)
- Maximilian Braun
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Chhavi Saini
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Jessica A Sun
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Lucy Q Shen
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Das V, Zhang F, Bower AJ, Li J, Liu T, Aguilera N, Alvisio B, Liu Z, Hammer DX, Tam J. Revealing speckle obscured living human retinal cells with artificial intelligence assisted adaptive optics optical coherence tomography. COMMUNICATIONS MEDICINE 2024; 4:68. [PMID: 38600290 PMCID: PMC11006674 DOI: 10.1038/s43856-024-00483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 03/13/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND In vivo imaging of the human retina using adaptive optics optical coherence tomography (AO-OCT) has transformed medical imaging by enabling visualization of 3D retinal structures at cellular-scale resolution, including the retinal pigment epithelial (RPE) cells, which are essential for maintaining visual function. However, because noise inherent to the imaging process (e.g., speckle) makes it difficult to visualize RPE cells from a single volume acquisition, a large number of 3D volumes are typically averaged to improve contrast, substantially increasing the acquisition duration and reducing the overall imaging throughput. METHODS Here, we introduce parallel discriminator generative adversarial network (P-GAN), an artificial intelligence (AI) method designed to recover speckle-obscured cellular features from a single AO-OCT volume, circumventing the need for acquiring a large number of volumes for averaging. The combination of two parallel discriminators in P-GAN provides additional feedback to the generator to more faithfully recover both local and global cellular structures. Imaging data from 8 eyes of 7 participants were used in this study. RESULTS We show that P-GAN not only improves RPE cell contrast by 3.5-fold, but also improves the end-to-end time required to visualize RPE cells by 99-fold, thereby enabling large-scale imaging of cells in the living human eye. RPE cell spacing measured across a large set of AI recovered images from 3 participants were in agreement with expected normative ranges. CONCLUSIONS The results demonstrate the potential of AI assisted imaging in overcoming a key limitation of RPE imaging and making it more accessible in a routine clinical setting.
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Affiliation(s)
- Vineeta Das
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Furu Zhang
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Andrew J Bower
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Joanne Li
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Tao Liu
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nancy Aguilera
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Bruno Alvisio
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Zhuolin Liu
- Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Daniel X Hammer
- Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Johnny Tam
- National Eye Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
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26
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Wang Y, Li C, Liu L, Yang Y, He X, Li G, Zheng X, Ren Y, Zhao H, Du Z, Jiang J, Kuang Y, Jia F, Yu H, Yang X. Association of Retinal Neurovascular Impairment with Disease Severity in Patients with Major Depressive Disorder: An Optical Coherence Tomography Angiography Study. Psychol Res Behav Manag 2024; 17:1573-1585. [PMID: 38617578 PMCID: PMC11015850 DOI: 10.2147/prbm.s443146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/27/2024] [Indexed: 04/16/2024] Open
Abstract
Background Identifying the fundus objective biomarkers for the major depressive disorders (MDD) may help promote mental health. The aim of this study was to evaluate retinal neurovascular changes and further investigate their association with disease severity in MDD. Methods This cross-sectional study conducted in the hospital enrolled patients with MDD and healthy controls.The retinal neurovascular parameters for all subjects, including vessel density (VD), thickness of ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL), and optic nerve head (ONH) eg are automatically calculated by the software in optical coherence tomography angiography (OCTA). The severity of MDD including depressive symptoms, anxiety, cognition, and insomnia was assessed by Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), and Insomnia Severity Index (ISI) respectively. Results This study included 74 MDD patients (n=74 eyes) and 60 healthy controls (HCs) (n=60 eyes). MDD patients showed significantly decreased VD of superficial and deep capillary plexus, thickness of GCC and RNFL, and volume of ONH (all p<0.05) and increased vertical cup-to-disc ratio and global loss volume (GLV) (all p<0.05) compared to HCs. Positive associations were found between HAMD scores and cup area (r=0.30, p=0.035), cup volume (r=0.31, p=0.029), and disc area (r=0.33, p=0.020) as well as ISI scores and RNFL thickness (r=0.34, p=0.047). Conclusion We found the retinal neurovascular impairment and its association with disease severity in MDD patients. OCTA showed promise as a potential complementary assessment tool for MDD.
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Affiliation(s)
- Yan Wang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Cong Li
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Lei Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Xue He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Gang Li
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Xianzhen Zheng
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Yun Ren
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- Shantou University Medical College, Shantou, People’s Republic of China
| | - Hanpeng Zhao
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Zhenchao Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- Shantou University Medical College, Shantou, People’s Republic of China
| | - Jianrong Jiang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yu Kuang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiaohong Yang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
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Wu JH, Moghimi S, Nishida T, Mahmoudinezhad G, Zangwill LM, Weinreb RN. Detection and agreement of event-based OCT and OCTA analysis for glaucoma progression. Eye (Lond) 2024; 38:973-979. [PMID: 37951976 PMCID: PMC10965992 DOI: 10.1038/s41433-023-02817-0] [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: 04/19/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE To examine event-based glaucoma progression using optical coherence tomography (OCT) and OCT angiography (OCTA). METHODS In this retrospective study, glaucoma eyes with ≥2-year and 4-visits of OCT/OCTA imaging were included. Peripapillary capillary density (CD) and retinal nerve fibre layer thickness (RNFL) were obtained from 4.5 mm × 4.5 mm optic nerve head (ONH) scans. Event-based OCT/OCTA progression was defined as decreases in ONH measurements exceeding test-retest variability on ≥2 consecutive visits. Visual field (VF) progression was defined as significant VF mean deviation worsening rates on ≥2 consecutive visits. Inter-instrument agreement on progression detection was compared using kappa(κ) statistics. RESULTS Among 147 eyes (89 participants), OCTA and OCT identified 33(22%) and 25(17%) progressors, respectively. They showed slight agreement (κ = 0.06), with 7(5%) eyes categorized as progressors by both. When incorporating both instruments, the rate of progressors identified increased to 34%. Similar agreement was observed in diagnosis- and severity-stratified analyses (κ < 0.10). Compared to progressors identified only by OCT, progressors identified only by OCTA tended to have thinner baseline RNFL and worse baseline VF. VF progression was identified in 11(7%) eyes. OCT and VF showed fair agreement (κ = 0.26), with 6(4%) eyes categorized as progressors by both. OCTA and VF showed slight agreement (κ = 0.08), with 4(3%) eyes categorized as progressors by both. CONCLUSIONS OCT and OCTA showed limited agreement on event-based progression detection, with OCT showing better agreement with VF. Both OCT and OCTA detected more progressors than VF. OCT and OCTA may provide valuable, yet different and complementary, information about glaucoma progression.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA.
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Williams PJ, Gregory A, Komro J, You Q, Ross B, Colón C, Juzych MS, Hughes BA, Ridha F. The impact of intraocular pressure on optical coherence tomography angiography: A review of current evidence. Saudi J Ophthalmol 2024; 38:144-151. [PMID: 38988792 PMCID: PMC11232753 DOI: 10.4103/sjopt.sjopt_112_23] [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: 05/19/2023] [Revised: 08/22/2023] [Accepted: 08/27/2023] [Indexed: 07/12/2024] Open
Abstract
A scoping review of 45 peer-reviewed manuscripts involving intraocular pressure (IOP) change and concurrent optical coherence tomography angiography (OCTA) assessments was performed to aggregate knowledge, summarize major findings, and identify gaps in literature and methodology relating to the effect of IOP change on OCTA. Articles were identified through PubMed/Medline, Google Scholar, Cochrane, Web of Science, and article reference lists. A total of 838 results were identified, and 45 articles met the inclusion and exclusion criteria for detailed analysis. OCTA metrics including vessel density (VD), perfusion density, and flow density of the superficial capillary plexus and the radial peripapillary capillaries were analyzed in relation to relative temporal IOP changes. Overall, IOP changes were found to affect superficial vascular plexus (VD) measurements on OCTA, especially when IOP elevated above the physiologic normal range (10-21 mmHg). No significant association was found between diurnal IOP variation and OCTA metrics. Cataract surgery improved the whole-image signal strength and VD regardless of changes in IOP. Beta-blockers were associated with paradoxically reduced vessel density in normal tension glaucoma patients in two studies. Although glaucoma surgical intervention studies were inconsistent and limited by scan quality and low sample sizes, patients requiring glaucoma surgery exhibited attenuated postoperative superficial VD recovery despite significant IOP reductions with surgical intervention. In addition to ensuring near-perfect signal strength with minimal media opacities and controlling for high myopia, central corneal thickness, and the presence of retinopathy, clinicians should consider the statistically significant impact of IOP on OCTA metrics when interpreting results.
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Affiliation(s)
- Parker J Williams
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
- Department of Ophthalmology, Ascension Eye Institute, Ascension Macomb-Oakland Hospital, Warren, MI, USA
- Department of Internal Medicine, Lakeland Regional Health Medical Center, Lakeland, FL, USA
| | - Andrew Gregory
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
| | - Jack Komro
- Department of Ophthalmology, Ascension Eye Institute, Ascension Macomb-Oakland Hospital, Warren, MI, USA
| | - Qisheng You
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
| | - Bing Ross
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
| | - Clara Colón
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
| | - Mark S Juzych
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
| | - Bret A Hughes
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
| | - Faisal Ridha
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, MI, USA
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29
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Li M, Huang K, Xu Q, Yang J, Zhang Y, Ji Z, Xie K, Yuan S, Liu Q, Chen Q. OCTA-500: A retinal dataset for optical coherence tomography angiography study. Med Image Anal 2024; 93:103092. [PMID: 38325155 DOI: 10.1016/j.media.2024.103092] [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: 12/23/2022] [Revised: 11/10/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
Optical coherence tomography angiography (OCTA) is a novel imaging modality that has been widely utilized in ophthalmology and neuroscience studies to observe retinal vessels and microvascular systems. However, publicly available OCTA datasets remain scarce. In this paper, we introduce the largest and most comprehensive OCTA dataset dubbed OCTA-500, which contains OCTA imaging under two fields of view (FOVs) from 500 subjects. The dataset provides rich images and annotations including two modalities (OCT/OCTA volumes), six types of projections, four types of text labels (age/gender/eye/disease) and seven types of segmentation labels (large vessel/capillary/artery/vein/2D FAZ/3D FAZ/retinal layers). Then, we propose a multi-object segmentation task called CAVF, which integrates capillary segmentation, artery segmentation, vein segmentation, and FAZ segmentation under a unified framework. In addition, we optimize the 3D-to-2D image projection network (IPN) to IPN-V2 to serve as one of the segmentation baselines. Experimental results demonstrate that IPN-V2 achieves an about 10% mIoU improvement over IPN on CAVF task. Finally, we further study the impact of several dataset characteristics: the training set size, the model input (OCT/OCTA, 3D volume/2D projection), the baseline networks, and the diseases. The dataset and code are publicly available at: https://ieee-dataport.org/open-access/octa-500.
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Affiliation(s)
- Mingchao Li
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Kun Huang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Qiuzhuo Xu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Jiadong Yang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Yuhan Zhang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Zexuan Ji
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Keren Xie
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, NanJing 210029, China.
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, NanJing 210029, China.
| | - Qinghuai Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, NanJing 210029, China.
| | - Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
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30
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Paczwa K, Rerych M, Romanowska-Próchnicka K, Olesińska M, Różycki R, Gołębiewska J. Retinal Microvasculature in Systemic Sclerosis Patients and the Correlation between Nailfold Capillaroscopic Findings and Optical Coherence Angiography Results. J Clin Med 2024; 13:2025. [PMID: 38610789 PMCID: PMC11012647 DOI: 10.3390/jcm13072025] [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: 02/27/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The comparison of retinal perfusion in the eyes of patients with systemic sclerosis (SSc) and in healthy controls using optical coherence tomography angiography (OCTA). The correlation between nailfold capillaroscopy results and OCTA findings among SSc. Methods: The study enrolled 31 patients with systemic sclerosis and 41 healthy controls. OCTA was performed in both groups to assess the retinal vasculature in the superficial (SCP) and deep (DCP) capillary plexuses and the foveal avascular zone (FAZ) area. Nailfold capillaroscopy (NC) was performed in SSc patients and compared to the FAZ area and the superficial and the deep vessel density. Results: In the SSc group, the parafoveal vessel density in DCP was significantly higher in relation to the mean value (p < 0.0001) and in each quadrant of the macula (p < 0.0001) compared to healthy subjects (p < 0.0001). The patients with early scleroderma patterns in capillaroscopy had a larger superficial and deep FAZ (p = 0.0104, p = 0.0076, respectively) than those with active and late patterns. There was a statistically significant difference in the FAZ when comparing early to active (p < 0.0001) and early to late scleroderma patterns (p < 0.0001). A statistically significant difference was found in the type of interstitial lung disease and the deep FAZ area (p = 0.0484). SSc patients with nonspecific interstitial pneumonia (NSIP) had a larger FAZ than those with usual interstitial pneumonia (UIP) (p = 0.0484). Moreover, NSIP cases had a higher parafoveal mean superficial vessel density than those with UIP (p = 0.0471). Conclusions: Our investigation showed that the peripheral microvascular system correlates with ocular microcirculatory impairment. The results indicate the important role of OCTA in the diagnosis, monitoring, and prognosis of microvascular changes in SSc.
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Affiliation(s)
- Katarzyna Paczwa
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| | - Magdalena Rerych
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| | - Katarzyna Romanowska-Próchnicka
- Department and Polyclinic of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Marzena Olesińska
- Department and Polyclinic of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Radosław Różycki
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| | - Joanna Gołębiewska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
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31
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Untracht GR, Durkee MS, Zhao M, Kwok-Cheung Lam A, Sikorski BL, Sarunic MV, Andersen PE, Sampson DD, Chen FK, Sampson DM. Towards standardising retinal OCT angiography image analysis with open-source toolbox OCTAVA. Sci Rep 2024; 14:5979. [PMID: 38472220 PMCID: PMC10933365 DOI: 10.1038/s41598-024-53501-6] [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: 08/15/2023] [Accepted: 02/01/2024] [Indexed: 03/14/2024] Open
Abstract
Quantitative assessment of retinal microvasculature in optical coherence tomography angiography (OCTA) images is important for studying, diagnosing, monitoring, and guiding the treatment of ocular and systemic diseases. However, the OCTA user community lacks universal and transparent image analysis tools that can be applied to images from a range of OCTA instruments and provide reliable and consistent microvascular metrics from diverse datasets. We present a retinal extension to the OCTA Vascular Analyser (OCTAVA) that addresses the challenges of providing robust, easy-to-use, and transparent analysis of retinal OCTA images. OCTAVA is a user-friendly, open-source toolbox that can analyse retinal OCTA images from various instruments. The toolbox delivers seven microvascular metrics for the whole image or subregions and six metrics characterising the foveal avascular zone. We validate OCTAVA using images collected by four commercial OCTA instruments demonstrating robust performance across datasets from different instruments acquired at different sites from different study cohorts. We show that OCTAVA delivers values for retinal microvascular metrics comparable to the literature and reduces their variation between studies compared to their commercial equivalents. By making OCTAVA publicly available, we aim to expand standardised research and thereby improve the reproducibility of quantitative analysis of retinal microvascular imaging. Such improvements will help to better identify more reliable and sensitive biomarkers of ocular and systemic diseases.
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Affiliation(s)
- Gavrielle R Untracht
- Department of Health Technology, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
- School of Biosciences, The University of Surrey, Guildford, GU27XH, UK
| | | | - Mei Zhao
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Andrew Kwok-Cheung Lam
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Bartosz L Sikorski
- Department of Ophthalmology, Nicolaus Copernicus University, 85-090, Bydgoszcz, Poland
- International Center for Translational Eye Research (ICTER), Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland
| | - Marinko V Sarunic
- Department of Medical Physics and Biomedical Engineering, University College London, London, WC1E6BT, UK
- Institute of Ophthalmology, University College London, London, EC1V2PD, UK
| | - Peter E Andersen
- Department of Health Technology, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - David D Sampson
- School of Computer Science and Electronic Engineering, The University of Surrey, Guildford, GU27XH, UK
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, 6009, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA, 6000, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, 3002, Australia
| | - Danuta M Sampson
- School of Biosciences, The University of Surrey, Guildford, GU27XH, UK.
- Institute of Ophthalmology, University College London, London, EC1V2PD, UK.
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, 6009, Australia.
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, 6009, Australia.
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Hormel TT, Liang GB, Wei X, Guo Y, Gao M, Wang J, Huang D, Bailey ST, Hwang TS, Jia Y. Visualizing features with wide-field volumetric OCT angiography. OPTICS EXPRESS 2024; 32:10329-10347. [PMID: 38571248 PMCID: PMC11018334 DOI: 10.1364/oe.510640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/16/2024] [Accepted: 02/14/2024] [Indexed: 04/05/2024]
Abstract
Optical coherence tomography (OCT) and its extension OCT angiography (OCTA) have become essential clinical imaging modalities due to their ability to provide depth-resolved angiographic and tissue structural information non-invasively and at high resolution. Within a field of view, the anatomic detail available is sufficient to identify several structural and vascular pathologies that are clinically relevant for multiple prevalent blinding diseases, including age-related macular degeneration (AMD), diabetic retinopathy (DR), and vein occlusions. The main limitation in contemporary OCT devices is that this field of view is limited due to a fundamental trade-off between system resolution/sensitivity, sampling density, and imaging window dimensions. Here, we describe a swept-source OCT device that can capture up to a 12 × 23-mm field of view in a single shot and show that it can identify conventional pathologic features such as non-perfusion areas outside of conventional fields of view. We also show that our approach maintains sensitivity sufficient to visualize novel features, including choriocapillaris morphology beneath the macula and macrophage-like cells at the inner limiting membrane, both of which may have implications for disease.
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Affiliation(s)
- Tristan T. Hormel
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
| | - Guangru B. Liang
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
| | - Xiang Wei
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA
| | - Yukun Guo
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA
| | - Min Gao
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA
| | - Jie Wang
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
| | - David Huang
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
| | - Steven T. Bailey
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
| | - Thomas S. Hwang
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
| | - Yali Jia
- Casey Eye Institutue, Oregon Health and Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA
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Ren C, Hao S, Wang F, Matt A, Amaral MM, Yang D, Wang L, Zhou C. Dynamic contrast optical coherence tomography (DyC-OCT) for label-free live cell imaging. Commun Biol 2024; 7:278. [PMID: 38448627 PMCID: PMC10918170 DOI: 10.1038/s42003-024-05973-5] [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: 09/04/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
Dynamic contrast optical coherence tomography (DyC-OCT), an emerging imaging method, utilizes fluctuation patterns in OCT signals to enhance contrast, thereby enabling non-invasive label-free volumetric live cell imaging. In this mini review, we explain the core concepts behind DyC-OCT image formation and its system configurations, serving as practical guidance for future DyC-OCT users. Subsequently, we explore its applications in delivering high-quality, contrast-enhanced images of cellular morphology, as well as in monitoring changes in cellular activity/viability assay experiments.
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Affiliation(s)
- Chao Ren
- Department of Biomedical Engineering, Washington University in St Louis, St. Louis, MO, USA
- Imaging Science Ph.D. Program, Washington University in St Louis, St. Louis, MO, USA
| | - Senyue Hao
- Department of Electrical & Systems Engineering, Washington University in St Louis, St. Louis, MO, USA
| | - Fei Wang
- Department of Biomedical Engineering, Washington University in St Louis, St. Louis, MO, USA
| | - Abigail Matt
- Department of Biomedical Engineering, Washington University in St Louis, St. Louis, MO, USA
| | - Marcello Magri Amaral
- Department of Biomedical Engineering, Washington University in St Louis, St. Louis, MO, USA
- Biomedical Engineering, Universidade Brasil, Sao Paulo, Brazil
| | - Daniel Yang
- Division of Allergy and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Leyao Wang
- Division of Allergy and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chao Zhou
- Department of Biomedical Engineering, Washington University in St Louis, St. Louis, MO, USA.
- Imaging Science Ph.D. Program, Washington University in St Louis, St. Louis, MO, USA.
- Department of Electrical & Systems Engineering, Washington University in St Louis, St. Louis, MO, USA.
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Hong J, Tan SS, Chua J. Optical coherence tomography angiography in glaucoma. Clin Exp Optom 2024; 107:110-121. [PMID: 38266148 DOI: 10.1080/08164622.2024.2306963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
The use of optical coherence tomography angiography (OCTA) holds significant promise for optometrists in the diagnosis and management of glaucoma. It offers reliable differentiation of glaucomatous eyes from healthy ones and extends monitoring capabilities for advanced cases. OCTA represents a valuable addition to traditional assessment methods, particularly in complex cases. Glaucoma, a major cause of irreversible blindness, is traditionally diagnosed using structural and functional metrics. With growing interest, OCTA is being explored to diagnose, monitor, and manage glaucoma. This review focuses on the application of OCTA in glaucoma patients. A database search was carried out using Embase Elsevier (n = 664), PubMed (n = 574), and Cochrane Central Register of Controlled Trials (n = 19) on 15 August 2023. After deduplication and screening, 272 original papers were included in the narrative review. Inclusion criteria comprised English-language original studies on OCTA use in human glaucoma patients, with or without healthy controls. Exclusion criteria encompassed animal studies, in-vivo/in-vitro research, reviews, and congress abstracts. OCTA has good repeatability and reproducibility. OCTA metrics have good discriminatory power to differentiate glaucomatous eyes from healthy eyes and show strong associations with structural changes and visual field defects. OCTA can extend the monitoring of advanced glaucoma, addressing the 'floor effect' of traditional structural measurements. OCTA metrics can be affected by the choice of OCTA machine, post-image processing algorithms, systemic diseases, and ocular factors. Image artefacts can affect the accuracy of OCTA measurements, and proper scan quality evaluation is crucial to ensure reliable results. Additionally, artificial intelligence techniques offer promise for enhancing the diagnostic accuracy of OCTA by combining data from various retinal layers and regions. OCTA complements traditional methods in assessing glaucoma, especially in challenging cases, providing valuable insights for detection and management. Further research and clinical validation are needed to integrate OCTA into routine practice.
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Affiliation(s)
- Jimmy Hong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Shayne S Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
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Gunasegaran G, Moghimi S, Nishida T, Walker E, Kamalipour A, Wu JH, Mahmoudinezhad G, Zangwill LM, Weinreb RN. Racial Differences in the Diagnostic Accuracy of OCT Angiography Macular Vessel Density for Glaucoma. Ophthalmol Glaucoma 2024; 7:197-205. [PMID: 37783272 DOI: 10.1016/j.ogla.2023.09.003] [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: 05/19/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To evaluate and compare the diagnostic accuracy of macular vessel density (VD) measured by OCT angiography (OCTA) in individuals of African descent (AD) and European descent (ED) with open-angle glaucoma. DESIGN Observational, cross sectional study. PARTICIPANTS A total of 176 eyes of 123 patients with glaucoma and 140 eyes of 88 healthy participants from the Diagnostic Innovations in Glaucoma Study. METHODS Whole-image ganglion cell complex (wiGCC) thickness and macular VD (parafoveal VD and perifoveal VD) were obtained from 6 × 6 macula scans. Area under the receiver operating characteristic (AUROC) curves were used to evaluate the diagnostic accuracy of macular VD and ganglion cell complex (GCC) thickness in AD and ED participants after adjusting for confounders such as age, visual field mean deviation (VF MD), signal strength index, axial length, self-reported hypertension and diabetes. MAIN OUTCOME MEASURES Macular VD and wiGCC measurements. RESULTS Parafoveal and perifoveal VD were significantly lower in ED than AD patients with glaucoma. Parafoveal and perifoveal VD performed significantly worse in AD participants compared with ED participants for detection of glaucoma (adjusted AUROC, 0.75 [95% confidence interval (CI), 0.62, 0.87], 0.85 [95% CI, 0.79, 0.90], P = 0.035; and 0.82 [95% CI, 0.70, 0.92], 0.91 [95% CI, 0.87, 0.94], respectively; P = 0.020). In contrast to VD, diagnostic accuracy of GCC thickness was similar in AD and ED individuals (adjusted AUROC, 0.89 [95% CI, 0.79, 0.96], 0.92 [95% CI, 0.86, 0.96], respectively; P = 0.313). The diagnostic accuracies of both macular VD and GCC thickness for differentiating between glaucoma and healthy eyes increased with increasing VF MD in both AD and ED participants. CONCLUSIONS Diagnostic performance of OCTA macular VD, but not GCC thickness, for glaucoma detection varies by race. Moreover, macular VD parameters had lower accuracy for detecting glaucoma in AD individuals than in ED individuals. The diagnostic performance of macular VD is race-dependent, and, therefore, race should be taken into consideration when interpreting macular OCTA results. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Gopikasree Gunasegaran
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Evan Walker
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Alireza Kamalipour
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Jo-Hsuan Wu
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Golnoush Mahmoudinezhad
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Linda M Zangwill
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego, La Jolla, California.
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Huang N, Hormel TT, Liang GB, Wei X, Guo Y, Chen S, Jia Y. Optimizing numerical k-sampling for swept-source optical coherence tomography angiography. OPTICS LETTERS 2024; 49:1201-1204. [PMID: 38426973 DOI: 10.1364/ol.518720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
High-quality swept-source optical coherence tomography (SS-OCT) requires accurate k-sampling, which is equally vital for optical coherence tomography angiography (OCTA). Most SS-OCT systems are equipped with hardware-driven k-sampling. However, this conventional approach raises concerns over system cost, optical alignment, imaging depth, and stability in the clocking circuit. This work introduces an optimized numerical k-sampling method to replace the additional k-clock hardware. Using this method, we can realize high axial resolution (4.9-µm full-width-half-maximum, in air) and low roll-off (2.3 dB loss) over a 4-mm imaging depth. The high axial resolution and sensitivity achieved by this simple numerical method can reveal anatomic and microvascular structures with structural OCT and OCTA in both macular and deeper tissues, including the lamina cribrosa, suggesting its usefulness in imaging retinopathy and optic neuropathy.
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Shen Y, Jethe JV, Hehir J, Amaral MM, Ren C, Hao S, Zhou C, Fisher JAN. Label free, capillary-scale blood flow mapping in vivo reveals that low intensity focused ultrasound evokes persistent dilation in cortical microvasculature. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.08.579513. [PMID: 38370686 PMCID: PMC10871316 DOI: 10.1101/2024.02.08.579513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Non-invasive, low intensity focused ultrasound (FUS) is an emerging neuromodulation technique that offers the potential for precision, personalized therapy. An increasing body of research has identified mechanosensitive ion channels that can be modulated by FUS and support acute electrical activity in neurons. However, neuromodulatory effects that persist from hours to days have also been reported. The brain's ability to provide targeted blood flow to electrically active regions involve a multitude of non-neuronal cell types and signaling pathways in the cerebral vasculature; an open question is whether persistent effects can be attributed, at least partly, to vascular mechanisms. Using a novel in vivo optical approach, we found that microvascular responses, unlike larger vessels which prior investigations have explored, exhibit persistent dilation. This finding and approach offers a heretofore unseen aspect of the effects of FUS in vivo and indicate that concurrent changes in neurovascular function may partially underly persistent neuromodulatory effects.
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Gao M, Hormel TT, Guo Y, Tsuboi K, Flaxel CJ, Huang D, Hwang TS, Jia Y. Perfused and Nonperfused Microaneurysms Identified and Characterized by Structural and Angiographic OCT. Ophthalmol Retina 2024; 8:108-115. [PMID: 37673397 DOI: 10.1016/j.oret.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Microaneurysms (MAs) have distinct, oval-shaped, hyperreflective walls on structural OCT, and inconsistent flow signal in the lumen with OCT angiography (OCTA). Their relationship to regional macular edema in diabetic retinopathy (DR) has not been quantitatively explored. DESIGN Retrospective, cross-sectional study. PARTICIPANTS A total of 99 participants, including 23 with mild, nonproliferative DR (NPDR), 25 with moderate NPDR, 34 with severe NPDR, and 17 with proliferative DR. METHODS We obtained 3 × 3-mm scans with a commercial device (Solix, Visionix/Optovue) in 99 patients with DR. Trained graders manually identified MAs and their location relative to the anatomic layers from cross-sectional OCT. Microaneurysms were first classified as perfused if flow signal was present in the OCTA channel. Then, perfused MAs were further classified into fully and partially perfused MAs based on the flow characteristics in en face OCTA. The presence of retinal fluid based on OCT near MAs was compared between perfused and nonperfused types. We also compared OCT-based MA detection to fundus photography (FP)- and fluorescein angiography (FA)-based detection. MAIN OUTCOME MEASURES OCT-identified MAs can be classified according to colocalized OCTA flow signal into fully perfused, partially perfused, and nonperfused types. Fully perfused MAs may be more likely to be associated with diabetic macular edema (DME) than those without flow. RESULTS We identified 308 MAs (166 fully perfused, 88 partially perfused, 54 nonperfused) in 42 eyes using OCT and OCTA. Nearly half of the MAs identified in this study straddle the inner nuclear layer and outer plexiform layer. Compared with partially perfused and nonperfused MAs, fully perfused MAs were more likely to be associated with local retinal fluid. The associated fluid volumes were larger with fully perfused MAs compared with other types. OCT/OCTA detected all MAs found on FP. Although not all MAs seen with FA were identified with OCT, some MAs seen with OCT were not visible with FA or FP. CONCLUSIONS OCT-identified MAs with colocalized flow on OCTA are more likely to be associated with DME than those without flow. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Min Gao
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Tristan T Hormel
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Yukun Guo
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon
| | - Kotaro Tsuboi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Christina J Flaxel
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon
| | - Thomas S Hwang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon.
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Arda H, Sonmez HK, Sener H, Buyukpatır Deneme E, Polat OA, Unlu M, Evereklioglu C, Horozoglu F. Parapapillary choroidal microvasculature in retrobulbar optic neuritis: An optical coherence tomography angiography study. Mult Scler Relat Disord 2024; 82:105343. [PMID: 38134608 DOI: 10.1016/j.msard.2023.105343] [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: 06/14/2023] [Revised: 07/06/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE To compare superficial and deep vascular characteristics of the optic disc in retrobulbar optic neuritis using optical coherence tomography angiography (OCT-A). METHODS Nineteen patients with unilateral non-infectious retrobulbar neuritis were included in the study. The contralateral eyes of each patient were served as controls. OCT-A scans of the optic discs were performed in a 4.5 × 4.5 mm rectangular area, while macular OCT-A scans were performed in a 6 × 6 mm rectangular area. Various parameters, including radial peripapillary capillary (RPC) density, peripapillary retinal nerve fibre layer (pRNFL) thickness, cup volume, rim area, disc area, cup-to-disc (c/d) area ratio, and vertical and horizontal c/d ratios were automatically obtained using the instrument software. The density for superficial capillary plexus (SCP) and deep capillary plexus (DCP) were assessed using macular OCT-A. Parapapillary choroidal microvascular (PPCMv) density was calculated using MATLAB software. RESULTS Parafoveal inferior, perifoveal total and inferior SCP densities were significantly decreased in eyes with optic neuritis when compared with contralateral control eyes in OCT-A measurements (respectively, p = 0.027, p = 0.041, p = 0.045). The axial lengths, (p = 0.72), vertical and horizontal cup-disc ratios, and disc area, cup-disc areas, cup volumes, and pRNFL thicknesses between the groups were similar (for each, p>0.05). CONCLUSIONS This study demonstrated for the first time that patients with retrobulbar optic neuritis had decreased SCP densities, though it did not cause any changes in PPCMv density.
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Affiliation(s)
- Hatice Arda
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye.
| | - Hatice Kubra Sonmez
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hidayet Sener
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Erinç Buyukpatır Deneme
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Osman Ahmet Polat
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Metin Unlu
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Cem Evereklioglu
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Fatih Horozoglu
- Department of Ophthalmology, Division of Neuro-ophthalmology, Erciyes University Medical Faculty, Kayseri, Türkiye
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Tombolini B, Crincoli E, Sacconi R, Battista M, Fantaguzzi F, Servillo A, Bandello F, Querques G. Optical Coherence Tomography Angiography: A 2023 Focused Update on Age-Related Macular Degeneration. Ophthalmol Ther 2024; 13:449-467. [PMID: 38180632 PMCID: PMC10787708 DOI: 10.1007/s40123-023-00870-2] [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: 09/14/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
Optical coherence tomography angiography (OCTA) has extensively enhanced our comprehension of eye microcirculation and of its associated diseases. In this narrative review, we explored the key concepts behind OCTA, as well as the most recent evidence in the pathophysiology of age-related macular degeneration (AMD) made possible by OCTA. These recommendations were updated since the publication in 2020, and are targeted for 2023. Importantly, as a future perspective in OCTA technology, we will discuss how artificial intelligence has been applied to OCTA, with a particular emphasis on its application to AMD study.
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Affiliation(s)
- Beatrice Tombolini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Emanuele Crincoli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Riccardo Sacconi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Marco Battista
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Federico Fantaguzzi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Andrea Servillo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Giuseppe Querques
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
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Huang BB, Fukuyama H, Burns SA, Fawzi AA. Imaging the Retinal Vascular Mural Cells In Vivo: Elucidating the Timeline of Their Loss in Diabetic Retinopathy. Arterioscler Thromb Vasc Biol 2024; 44:465-476. [PMID: 38152885 PMCID: PMC10842708 DOI: 10.1161/atvbaha.123.320169] [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: 09/15/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Vascular mural cells (VMCs) are integral components of the retinal vasculature with critical homeostatic functions such as maintaining the inner blood-retinal barrier and vascular tone, as well as supporting the endothelial cells. Histopathologic donor eye studies have shown widespread loss of pericytes and smooth muscle cells, the 2 main VMC types, suggesting these cells are critical to the pathogenesis of diabetic retinopathy (DR). There remain, however, critical gaps in our knowledge regarding the timeline of VMC demise in human DR. METHODS In this study, we address this gap using adaptive optics scanning laser ophthalmoscopy to quantify retinal VMC density in eyes with no retinal disease (healthy), subjects with diabetes without diabetic retinopathy, and those with clinical DR and diabetic macular edema. We also used optical coherence tomography angiography to quantify capillary density of the superficial and deep capillary plexuses in these eyes. RESULTS Our results indicate significant VMC loss in retinal arterioles before the appearance of classic clinical signs of DR (diabetes without diabetic retinopathy versus healthy, 5.0±2.0 versus 6.5±2.0 smooth muscle cells per 100 µm; P<0.05), while a significant reduction in capillary VMC density (5.1±2.3 in diabetic macular edema versus 14.9±6.0 pericytes per 100 µm in diabetes without diabetic retinopathy; P=0.01) and capillary density (superficial capillary plexus vessel density, 37.6±3.8 in diabetic macular edema versus 45.5±2.4 in diabetes without diabetic retinopathy; P<0.0001) is associated with more advanced stages of clinical DR, particularly diabetic macular edema. CONCLUSIONS Our results offer a new framework for understanding the pathophysiologic course of VMC compromise in DR, which may facilitate the development and monitoring of therapeutic strategies aimed at VMC preservation and potentially the prevention of clinical DR and its associated morbidity. Imaging retinal VMCs provides an unparalleled opportunity to visualize these cells in vivo and may have wider implications in a range of diseases where these cells are disrupted.
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Affiliation(s)
- Bonnie B. Huang
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Hisashi Fukuyama
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Ophthalmology, Hyogo Medical University, Hyogo, Japan
| | | | - Amani A. Fawzi
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Gao M, Guo D, Wang J, Tan Y, Liu K, Gao L, Zhang Y, Ding Z, Gu Y, Li P. High-accuracy noninvasive continuous glucose monitoring using OCT angiography-purified blood scattering signals in human skin. BIOMEDICAL OPTICS EXPRESS 2024; 15:991-1003. [PMID: 38404306 PMCID: PMC10890863 DOI: 10.1364/boe.506092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/21/2023] [Accepted: 01/15/2024] [Indexed: 02/27/2024]
Abstract
The accuracy of noninvasive continuous glucose monitoring (CGM) through near-infrared scattering is challenged by mixed scattering signals from different compartments, where glucose has a positive correlation with a blood scattering coefficient but a negative correlation with a tissue scattering coefficient. In this study, we developed a high-accuracy noninvasive CGM based on OCT angiography (OCTA)-purified blood scattering signals. The blood optical scattering coefficient (BOC) was initially extracted from the depth attenuation of backscattered light in OCT and then purified by eliminating the scattering signals from the surrounding tissues under the guidance of a 3D OCTA vascular map in human skin. The purified BOC was used to estimate the optical blood glucose concentration (BGC) through a linear calibration. The optical and reference BGC measurements were highly correlated (R = 0.94) without apparent time delay. The mean absolute relative difference was 6.09%. All optical BGC measurements were within the clinically acceptable Zones A + B, with 96.69% falling in Zone A on Parke's error grids. The blood glucose response during OGTT was mapped with a high spatiotemporal resolution of the single vessel and 5 seconds. This noninvasive OCTA-based CGM shows promising accuracy for clinical use. Future research will involve larger sample sizes and diabetic participants to confirm these preliminary findings.
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Affiliation(s)
- Mengqin Gao
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Dayou Guo
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Jiahao Wang
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Yizhou Tan
- Department of Laser Medicine, First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Kaiyuan Liu
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Lei Gao
- Jiaxing Key Laboratory of Photonic Sensing and Intelligent Imaging, Jiaxing 314000, China
- Intelligent Optics and Photonics Research Center, Jiaxing Research Institute, Zhejiang University, Jiaxing 314000, China
| | - Yulei Zhang
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Zhihua Ding
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
| | - Ying Gu
- Department of Laser Medicine, First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Peng Li
- State Key Lab of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
- Jiaxing Key Laboratory of Photonic Sensing and Intelligent Imaging, Jiaxing 314000, China
- Intelligent Optics and Photonics Research Center, Jiaxing Research Institute, Zhejiang University, Jiaxing 314000, China
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Wu JH, Moghimi S, Nishida T, Walker E, Kamalipour A, Li E, Mahmoudinezhad G, Zangwill LM, Weinreb RN. Evaluation of the long-term variability of macular OCT/OCTA and visual field parameters. Br J Ophthalmol 2024; 108:211-216. [PMID: 36585126 PMCID: PMC10310881 DOI: 10.1136/bjo-2022-322470] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS To assess the long-term variability of macular optical coherence tomography (OCT)/OCT angiography (OCTA) and visual field (VF) parameters. METHODS Healthy and glaucoma eyes with ≥1-year follow-up were included. 24-2 VF and macular OCT/OCTA parameters, including VF mean deviation (MD), whole-image vessel density (wiVD) and ganglion cell complex thickness (wiGCC) were analysed. Intraclass correlation coefficient (ICC), root mean squared error (RMSE), within-subject test-retest SD (Sw) and test-retest variability were calculated for stable eye cohort (max follow-up=1.5 years). Rates of change and RMSE were evaluated in the extended cohort including all eyes (unlimited follow-up). RESULTS From a total of 230 eyes (150 participants; age=67.7 years), 86 eyes (37%, 62 participants) were stable. In stable eyes, OCT parameters showed the highest mean (95%) ICC (wiGCC=0.99 (0.99, 0.99)), followed by VF (VF MD=0.91 (0.88, 0.93)) and OCTA (wiVD=0.82 (0.75, 0.87)). RMSE and Sw for VF MD were 0.92 dB and 0.81 dB, respectively, for wiVD were 1.64% and 1.48%, respectively, and for wiGCC, 0.91 µm and 0.78 µm, respectively. The long-term test-rest variability of VF MD, wiVD and wiGCC was 2.2 dB, 4.1% and 2.2 µm, respectively. In the extended cohort (mean follow-up=3.0 years), all parameters had significant rates of change (p<0.001), and compared with the stable cohort, only slightly higher RMSE (VF MD=1.07 dB; wiGCC=2.03 µm; wiVD=2.57%) were found. CONCLUSIONS VF and macular OCT/OCTA, particularly OCT parameters, showed small long-term variability in all eyes, including stable ones, supporting the use of these instruments in glaucoma follow-up. Changes in macular VD and GCC greater than 4%-5% and 2 µm, respectively, indicate possible progression. TRIAL REGISTRATION NUMBER NCT00221897.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Evan Walker
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Elizabeth Li
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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Maruko I, Irie K, Hasegawa T, Takagi M, Iida T. Misalignment of center of foveal avascular zone and center of photoreceptors in eyes with history of retinopathy of prematurity. Sci Rep 2024; 14:2017. [PMID: 38263428 PMCID: PMC10805909 DOI: 10.1038/s41598-024-52407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024] Open
Abstract
To determine the relationship between the center of the foveal avascular zone (FAZ) and the center of the foveal photoreceptors in eyes with a history of retinopathy of prematurity (ROP). To accomplish this, we reviewed the medical records of patients with ROP who were examined at the ROP Clinic of the Tokyo Women's Medical University Hospital. We studied 43 eyes of 23 children with ROP and 67 eyes of 36 control children without any fundus abnormalities. The optical coherence tomography angiographic (OCTA) en face images were used to measure the size and location of the foveal avascular zone (FAZ), and cross-sectional OCT images to measure the central retinal thickness (CRT). Our results showed that the size of the FAZ was significantly smaller in the ROP group (0.200 ± 0.142 mm2) than in the control group (0.319 ± 0.085 mm2; P < 0.01). The CRT was significantly thicker in the ROP group (228 ± 30 µm) than in the control group (189 ± 13 µm; P < 0.01). The mean length of the foveal bulge was not significantly different between the two groups. The actual distance of the misalignment between the center of the FAZ and the center of the photoreceptors was significantly greater in the ROP group (50.4 ± 29.5 µm) than in the control group (39.6 ± 21.9 µm; P = 0.001). The correlations between the actual distance of misalignment and the size of the FAZ, CRT, and length of the foveal bulge in both groups were not significant. Despite the significant misalignment in eyes with a history of ROP, the center of the foveal photoreceptors was consistently located within the narrow FAZ which indicates that the development of the FAZ and photoreceptor formation are interrelated.
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Affiliation(s)
- Ichiro Maruko
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
| | - Kotaro Irie
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Taiji Hasegawa
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Manami Takagi
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
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Vidal-Oliver L, Gallego-Pinazo R, Dolz-Marco R. Astigmatism Influences Quantitative and Qualitative Analysis in Optical Coherence Tomography Angiography Imaging. Transl Vis Sci Technol 2024; 13:10. [PMID: 38224331 PMCID: PMC10795549 DOI: 10.1167/tvst.13.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose The purpose of this paper was to study the influence of astigmatism in optical coherence tomography angiography (OCTA) images in a quantitative and qualitative analysis. Methods This was a prospective, cross-sectional study. We included 110 eyes of 110 patients: 20 eyes without astigmatism and 90 eyes with astigmatism ≥0.5 diopters (D). We performed a macula centered OCTA as a reference image. In patients without astigmatism, registered follow-up scans were performed after induction of -1 and -2 D astigmatism. In patients with astigmatism, we performed the follow-up scan after astigmatism correction. We used a set of cylindrical lenses attached to the camera head of the SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany). A quantitative and qualitative analysis of the superficial vascular complex (SVC) and deep vascular complex (DVC) was performed. The main outcome measures were vessel density (VD), image quality, and the presence of artifacts. Results Mean VD of the SVC was significantly higher in the reference images compared with the images after induction of -2 D. Differences with -1 D were nonsignificant. Higher degrees of astigmatisms had higher VD dropout (0.012-0.02 per diopter in SVC). Astigmatism axis showed no relevance in our cohort. Image quality assessed by two independent observers was graded as higher in images without astigmatism. Defocus and attenuation were more prevalent in images with astigmatism. Conclusions Astigmatism of -2 D affects quantification of VD in OCTA images, mainly affecting the SVC, as well as the subjective quality assessment. Correction of this refractive error might be necessary for an accurate quantitative assessment of OCTA images. Translational Relevance Correcting astigmatism of 2 D or greater appears to be necessary when analyzing OCTA images.
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Affiliation(s)
- Lourdes Vidal-Oliver
- Fundación Oftalmología Médica de la Comunidad Valenciana, Valencia, Spain
- Macula Unit, Oftalvist Clinic, Valencia, Spain
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Zang P, Hormel TT, Wang J, Guo Y, Bailey ST, Flaxel CJ, Huang D, Hwang TS, Jia Y. Interpretable Diabetic Retinopathy Diagnosis Based on Biomarker Activation Map. IEEE Trans Biomed Eng 2024; 71:14-25. [PMID: 37405891 PMCID: PMC10796196 DOI: 10.1109/tbme.2023.3290541] [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] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Deep learning classifiers provide the most accurate means of automatically diagnosing diabetic retinopathy (DR) based on optical coherence tomography (OCT) and its angiography (OCTA). The power of these models is attributable in part to the inclusion of hidden layers that provide the complexity required to achieve a desired task. However, hidden layers also render algorithm outputs difficult to interpret. Here we introduce a novel biomarker activation map (BAM) framework based on generative adversarial learning that allows clinicians to verify and understand classifiers' decision-making. METHODS A data set including 456 macular scans were graded as non-referable or referable DR based on current clinical standards. A DR classifier that was used to evaluate our BAM was first trained based on this data set. The BAM generation framework was designed by combing two U-shaped generators to provide meaningful interpretability to this classifier. The main generator was trained to take referable scans as input and produce an output that would be classified by the classifier as non-referable. The BAM is then constructed as the difference image between the output and input of the main generator. To ensure that the BAM only highlights classifier-utilized biomarkers an assistant generator was trained to do the opposite, producing scans that would be classified as referable by the classifier from non-referable scans. RESULTS The generated BAMs highlighted known pathologic features including nonperfusion area and retinal fluid. CONCLUSION/SIGNIFICANCE A fully interpretable classifier based on these highlights could help clinicians better utilize and verify automated DR diagnosis.
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Affiliation(s)
- Pengxiao Zang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239 USA
| | - Tristan T. Hormel
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
| | - Jie Wang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239 USA
| | - Yukun Guo
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239 USA
| | - Steven T. Bailey
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
| | - Christina J. Flaxel
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239 USA
| | - Thomas S. Hwang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239 USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239 USA
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Lee M, Bang H, Lee E, Park S, Yoo H, Oh WY, Lee S. Imaging peritoneal blood vessels through optical coherence tomography angiography for laparoscopic surgery. JOURNAL OF BIOPHOTONICS 2024; 17:e202300221. [PMID: 37675626 DOI: 10.1002/jbio.202300221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/20/2023] [Accepted: 09/05/2023] [Indexed: 09/08/2023]
Abstract
Laparoscopic surgery presents challenges in identifying blood vessels due to lack of tactile feedback. The image-guided laparoscopic surgical tool (IGLaST) integrated with optical coherence tomography (OCT) has potential for in vivo blood vessel imaging; however, distinguishing vessels from surrounding tissue remains a challenge. In this study, we propose utilizing an inter-A-line intensity differentiation-based OCT angiography (OCTA) to improve visualization of blood vessels. By evaluating a tissue phantom with varying flow speeds, we optimized the system's blood flow imaging capabilities in terms of minimum detectable flow and contrast-to-noise ratio. In vivo experiments on rat and porcine models, successfully visualized previously unidentified blood vessels and concealed blood flows beneath the 1 mm depth peritoneum. Qualitative comparison of various OCTA algorithms indicated that the intensity differentiation-based algorithm performed best for our application. We believe that implementing IGLaST with OCTA can enhance surgical outcomes and reduce procedure time in laparoscopic surgeries.
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Affiliation(s)
- Minsuk Lee
- Medical Device Development Center, Osong Medical Innovation Foundation, Cheongju, Chungbuk, Korea
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Hyeonjin Bang
- Medical Device Development Center, Osong Medical Innovation Foundation, Cheongju, Chungbuk, Korea
| | - Eungjang Lee
- Medical Device Development Center, Osong Medical Innovation Foundation, Cheongju, Chungbuk, Korea
| | - Sungsoo Park
- Division of Foregut Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea
- Department of Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hongki Yoo
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Wang-Yuhl Oh
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Seungrag Lee
- Medical Device Development Center, Osong Medical Innovation Foundation, Cheongju, Chungbuk, Korea
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Arish M, Momeni-Moghaddam H, Alborzi M, Maleki A, Daneshvar R, Heidari HR. Peripapillary vessel density in healthy people, primary open-angle glaucoma, and normal-tension glaucoma. Eur J Ophthalmol 2024; 34:161-167. [PMID: 37312517 DOI: 10.1177/11206721231181929] [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] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To compare peripapillary vessel density using optical coherence tomography angiography (OCT-A) in eyes of healthy people, primary open-angle glaucoma (POAG), and normal-tension glaucoma (NTG). METHODS Thirty patients with POAG, 27 patients with NTG, and 29 healthy individuals in the control group were assessed. Capillary vessels in peripapillary retinal nerve fiber layer (RNFL) represented by whole image RPC (radial peripapillary capillary) density in an AngioDisc scan 4.5 × 4.5 mm centered on the optic disc, and ONH morphological variables (disc area, rim area, cup to disc area ratio (CDR)), and average peripapillary RNFL thickness were measured. RESULTS Differences in mean RPC, RNFL, disc area, rim area, and CDR between the groups were statistically significant (P < 0.05). The difference in RNFL thickness and rim area was not significant between NTG and healthy groups, while RPC and CDR showed a statistically significant difference between all pairs. The vessel density in the POAG group was 8.25% and 11.7% lower compared to the NTG and healthy groups, respectively; while the mean difference was less (2.97%) for the NTG and healthy group. In the POAG group, 67.2% of the variation in RPC can be explained by a model containing CDR and RNFL thickness, and in normal eyes 38.8% of the changes using a model containing RNFL. CONCLUSION The peripapillary vessel density is reduced in both types of glaucoma. The vessel density in NTG was significantly lower than in the healthy eyes, despite the lack of significant difference in RNFL thickness and neuroretinal rim area between them.
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Affiliation(s)
- Mohammad Arish
- Department of Ophthalmology, Al-Zahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamed Momeni-Moghaddam
- Rehabilitation Sciences Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Moniba Alborzi
- Department of Ophthalmology, Al-Zahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Maleki
- Department of Ophthalmology, Al-Zahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Hamid-Reza Heidari
- Optometry Department, Mashhad University of Medical Sciences, Mashhad, Iran
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Tsai WS, Thottarath S, Gurudas S, Pearce E, Giani A, Sivaprasad S. Topographic Correlation of Microperimetry With Structural Characteristics in Diabetic Macular Ischemia. Am J Ophthalmol 2024; 257:25-33. [PMID: 37714283 DOI: 10.1016/j.ajo.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE This study aimed to determine the threshold for defining abnormal retinal sensitivity (RS) that correlates with structural changes in diabetic macular ischemia (DMI) patients with stable treated proliferative diabetic retinopathy (PDR). DESIGN Prospective cross-sectional study. METHODS In a single center, we recruited 85 eyes (67 patients) with stable treated PDR with best-corrected visual acuity (BCVA) ≥54 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (Snellen equivalent 20/80) and optical coherence tomography angiography evidence of DMI. The function-function and function-structure correlation were assessed. Two preselected thresholds in overall RS (oRS), 25 decibels (dB) and age-matched normative data (AMND), were tested on their ability to reflect abnormal anatomy in DMI. Finally, a multivariable regression model was established to depict the relationship between the oRS and various parameters. RESULTS The oRS showed only a modest correlation with BCVA and low-luminance visual acuity (LLVA). The whole-image deep vessel density (wiDVD) was the most reliable vascular metric correlated with RS. For every 1% decline in the wiDVD, the oRS decreased by 0.37 dB (P < .001) after multivariable adjustment. Furthermore, both a reduction of oRS to <25 dB or below AMND could differentiate eyes with FAZ ≥0.5 mm2, whole image superficial vessel density (wiSVD) <37.7%, wiDVD <41.9%, and the presence of disorganization of the retinal inner layers (DRIL) from their counterparts. CONCLUSIONS The absolute value of 25 dB in oRS is worth considering as a trial endpoint, because it does not require complex calculation and closely reflects the structural abnormalities in DMI.
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Affiliation(s)
- Wei-Shan Tsai
- From Moorfields Clinical Research Facility (W.-S.T., S.T., S.G., S.S.), NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Sridevi Thottarath
- From Moorfields Clinical Research Facility (W.-S.T., S.T., S.G., S.S.), NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Sarega Gurudas
- From Moorfields Clinical Research Facility (W.-S.T., S.T., S.G., S.S.), NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Elizabeth Pearce
- Boehringer Ingelheim Pharmaceuticals Inc.(E.P.), Ridgefield, CT, USA
| | - Andrea Giani
- Boehringer Ingelheim (A.G.), Binger Strasse 173, 55216 Ingelheim am Rhein, Germany
| | - Sobha Sivaprasad
- From Moorfields Clinical Research Facility (W.-S.T., S.T., S.G., S.S.), NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology (S.S.), University College London, London, UK.
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Abdolrahimzadeh S, Zweifel SA, Di Pippo M, Bajka A, Scuderi G, Lotery AJ. Central macular choriocapillaris impairment as a manifestation of microvascular disease in eyes with subretinal drusenoid deposits. Eye (Lond) 2024; 38:173-178. [PMID: 37419959 PMCID: PMC10764916 DOI: 10.1038/s41433-023-02654-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND/OBJECTIVES Microvascular alterations and choroidal impairment are emerging as a pathologic pathway in age-related macular degeneration (AMD). This study aimed to evaluate the central macular choriocapillaris (CC) in eyes with subretinal drusenoid deposits (SDD) and the retinal microvasculature in patients with early AMD phenotypes. SUBJECTS/METHODS This was an institutional, multicentric observational cross-sectional study. Ninety-nine eyes of 99 subjects; 33 eyes with SDD only, 33 eyes with conventional drusen (CD) only, and 33 eyes of healthy age-matched subjects were included. Comprehensive ophthalmologic examination and optical coherence tomography angiography (OCTA) was performed. The central macular flow area of the CC was analysed in the SDD group and the vessel density of the retinal superficial capillary plexus (SCP) and deep capillary plexus (DCP) was analysed in the SDD and CD groups using automated OCTA output parameters. RESULTS The flow area of the CC in the SDD group was significantly reduced (p ≤ 0.001) with respect to the healthy control group. There was a trend of reduction of vessel density of the SCP and the DCP in the SDD and CD group with respect to controls, although this did not reach statistical significance. CONCLUSIONS OCTA data in the present report corroborate the role of vascular damage in early AMD with CC impairment in the central macular area in eyes with SDD.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy.
- St. Andrea Hospital, Via di Grottarossa 1035/1039, Rome, Italy.
| | - Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital Zurich (USZ), University of Zurich, Zurich, Switzerland
| | - Mariachiara Di Pippo
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Anahita Bajka
- Department of Ophthalmology, University Hospital Zurich (USZ), University of Zurich, Zurich, Switzerland
| | - Gianluca Scuderi
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
- St. Andrea Hospital, Via di Grottarossa 1035/1039, Rome, Italy
| | - Andrew John Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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