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Ostrin LA, Harb E, Nickla DL, Read SA, Alonso-Caneiro D, Schroedl F, Kaser-Eichberger A, Zhou X, Wildsoet CF. IMI-The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37126359 PMCID: PMC10153586 DOI: 10.1167/iovs.64.6.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The choroid is the richly vascular layer of the eye located between the sclera and Bruch's membrane. Early studies in animals, as well as more recent studies in humans, have demonstrated that the choroid is a dynamic, multifunctional structure, with its thickness directly and indirectly subject to modulation by a variety of physiologic and visual stimuli. In this review, the anatomy and function of the choroid are summarized and links between the choroid, eye growth regulation, and myopia, as demonstrated in animal models, discussed. Methods for quantifying choroidal thickness in the human eye and associated challenges are described, the literature examining choroidal changes in response to various visual stimuli and refractive error-related differences are summarized, and the potential implications of the latter for myopia are considered. This review also allowed for the reexamination of the hypothesis that short-term changes in choroidal thickness induced by pharmacologic, optical, or environmental stimuli are predictive of future long-term changes in axial elongation, and the speculation that short-term choroidal thickening can be used as a biomarker of treatment efficacy for myopia control therapies, with the general conclusion that current evidence is not sufficient.
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Affiliation(s)
- Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, United States
| | - Elise Harb
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
| | - Debora L Nickla
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, Massachusetts, United States
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Falk Schroedl
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Alexandra Kaser-Eichberger
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Xiangtian Zhou
- Eye Hospital and School of Optometry and Ophthalmology, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Christine F Wildsoet
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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The Assessment of Acute Chorioretinal Changes Due to Intensive Physical Exercise in Senior Elite Athletes. J Aging Phys Act 2022; 31:497-505. [PMID: 36640780 DOI: 10.1123/japa.2022-0231] [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: 07/11/2022] [Revised: 09/03/2022] [Accepted: 09/23/2022] [Indexed: 12/25/2022]
Abstract
Regular physical exercise is known to lower the incidence of age-related eye diseases. We aimed to assess the acute chorioretinal alterations in older adults following intense physical strain. Seventeen senior elite athletes were recruited who underwent an aerobic exercise on a cycle ergometer and macular scanning by optical coherence tomography. A significant thinning of the entire retina was observed 1 min after exercise, followed by a thickening at 5 min, after which the thickness returned to baseline. This trend was similar in almost every single retinal layer, although a significant change was observed only in the inner retina. Choroidal thickness changes were neither significant nor did they correlate with the thickness changes of intraretinal layers. The mechanism of how these immediate retinal changes chronically impact age-related sight-threatening pathologies that, in turn, result in a substantially reduced quality of life warrants further investigation on nontrained older adults as well.
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Lu Y, Zhou H, Zhou X, Chen Y, Wang RK. Correlation Between Laser Speckle Flowgraphy and OCT-Derived Retinal and Choroidal Metrics in Healthy Human Eye. Transl Vis Sci Technol 2022; 11:15. [PMID: 35704328 PMCID: PMC9206497 DOI: 10.1167/tvst.11.6.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/17/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To investigate the correlation between laser speckle flowgraphy (LSFG) signals and the quantitative metrics derived from optical coherence tomography (OCT) in normal eyes. Methods LSFG, OCT, and OCT angiography (OCTA) imaging were performed on normal participants using a custom-designed LSFG system and a commercial swept-source OCT system. Mean (PWM) and amplitude (PWA) of the LSFG pulse waveform were selected to quantify the LSFG signals. Retinal and choroidal maps were obtained using the standard 6 × 6 mm OCT and OCTA scans. Structural and vascular metrics maps, including thickness, vessel area density, vessel skeleton density, and vessel diameter index of the retina, and choroidal thickness (CT), choroidal vessel volume (CVV) and choroidal vessel index (CVI), were employed to quantify the retinal and choroidal properties. Correlation analysis was then performed between the LSFG, retinal, and choroidal metrics maps. Results Twelve healthy participants aged 23 to 36 years were enrolled in this study. The spatial distribution of the PWM and PWA values was highly correlated with that of the CT and CVV metrics. On average, Spearman correlation coefficients (ρ) were 0.80 and 0.78 (all P < 0.001) for the correlations between PWM and CT and CVV, respectively, and were 0.61 and 0.63 (all P < 0.05) for the correlations between PWA and CT and CVV, respectively. In comparison, both PWM and PWA were generally weak or not correlated with all the retinal metrics and CVI. Conclusions LSFG signals were positively correlated with the choroidal thickness and vessel volume, suggesting choroidal blood flows dominate the LSFG signals at the area absent of large retinal vessels. Translational Relevance This study illustrates the dominant source of the LSFG signals in the eye.
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Affiliation(s)
- Yiming Lu
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Hao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Xiao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Yuxuan Chen
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Karalis Johnson Retina Center, Department of Ophthalmology, University of Washington, Seattle, WA, USA
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Szalai I, Csorba A, Pálya F, Jing T, Horváth E, Bosnyák E, Györe I, Nagy ZZ, DeBuc DC, Tóth M, Somfai GM. The assessment of acute chorioretinal changes due to intensive physical exercise in young adults. PLoS One 2022; 17:e0268770. [PMID: 35613112 PMCID: PMC9132279 DOI: 10.1371/journal.pone.0268770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 05/08/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose
There is abundant evidence on the benefits of physical activity on cardiovascular health. However, there are only few data on the acute effects of physical exercise on the retina and choroid. Our aim was the in vivo examination of chorioretinal alterations following short intense physical activity by spectral domain optical coherence tomography (SD-OCT).
Methods
Twenty-one eyes of 21 healthy, young subjects (mean age 22.5 ± 4.1 years, 15 males and 6 females) were recruited. Macular scanning with a SD-OCT was performed before and following a vita maxima-type physical strain exercise on a rowing ergometer until complete fatigue. Follow-up OCT scans were performed 1, 5, 15, 30 and 60 minutes following the exercise. The OCT images were exported and analyzed using our custom-built OCTRIMA 3D software and the thickness of 7 retinal layers was calculated, along with semi-automated measurement of the choroidal thickness. One-way ANOVA analysis was performed followed by Dunnett post hoc test for the thickness change compared to baseline and the correlation between performance and thickness change has also been calculated. The level of significance was set at 0.001.
Results
We observed a significant thinning of the total retina 1 minute post-exercise (-7.3 ± 0.6 μm, p < 0.001) which was followed by a significant thickening by 5 and 15 minutes (+3.6 ± 0.6 μm and +4.0 ± 0.6 μm, respectively, both p <0.001). Post-exercise retinal thickness returned to baseline by 30 minutes. This trend was present throughout the most layers of the retina, with significant changes in the ganglion cell–inner plexiform layer complex, (-1.3 ± 0.1 μm, +0.6 ± 0.1 μm and +0.7 ± 0.1 μm, respectively, p <0.001 for all), in the inner nuclear layer at 1 and 5 minutes (-0.8 ± 0.1 μm and +0.8 ± 0.1 μm, respectively, p <0.001 for both), in the outer nuclear layer–photoreceptor inner segment complex at 5 minute (+2.3 ± 0.4 μm, p <0.001 for all) and in the interdigitation zone–retinal pigment epithelium complex at 1 and 15 minutes (-3.3 ± 0.4 μm and +1.8 ± 0.4 μm, respectively, p <0.001 for both). There was no significant change in choroidal thickness; however, we could detect a tendency towards thinning at 1, 15, and 30 minutes following exercise. The observed changes in thickness change did not correlate with performance. Similar trends were observed in both professional and amateur sportsmen (n = 15 and n = 6, respectively). The absolute changes in choroidal thickness did not show any correlation with the thickness changes of the intraretinal layers.
Conclusions
Our study implies that in young adults, intense physical exercise has an acute effect on the granular layers of the retina, resulting in thinning followed by rebound thickening before normalization. We could not identify any clear correlation with either choroidal changes or performance that might explain our observations, and hence the exact mechanism warrants further clarification. We believe that a combination of vascular and mechanic changes is behind the observed trends.
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Affiliation(s)
- Irén Szalai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Anita Csorba
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Fanni Pálya
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Tian Jing
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | | | - Edit Bosnyák
- Department of Health Sciences and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - István Györe
- Department of Health Sciences and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Delia Cabrera DeBuc
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | - Miklós Tóth
- Department of Health Sciences and Sport Medicine, University of Physical Education, Budapest, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Márk Somfai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Department of Ophthalmology, Stadtspital, Zürich, Switzerland
- Spross Research Institute, Zürich, Switzerland
- * E-mail:
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The impact of vascular risk factors on the thickness and volume of the choroid in AMD patients. Sci Rep 2021; 11:15106. [PMID: 34302055 PMCID: PMC8302717 DOI: 10.1038/s41598-021-94676-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/29/2021] [Indexed: 11/08/2022] Open
Abstract
Disturbances in choroidal microcirculation may lead to the onset and progression of age-related macular degeneration (AMD). We aimed to assess changes in the choroidal volume and thickness in the macular region in AMD eyes and to investigate whether coexisting vascular risk factors alter choroidal status. We enrolled 354 AMD patients (175 dry, 179 wet AMD) and 121 healthy controls. All participants underwent a complete ophthalmologic examination and assessment of choroidal thickness and volume. A multivariate analysis adjusted for age, sex, and smoking status revealed that wet AMD was an independent factor associated with higher average thickness of the central ring area (ATC) and average volume of the central ring area (AVC) and lower choroidal vascularity index (CVI) compared to controls (β = + 0.18, p = 0.0007, β = + 0.18, p = 0.0008, respectively) and to dry AMD (β = + 0.17, p = 0.00003 for both ATC and AVC and β = - 0.30 p < 0.0001 for CVI). ATC, AVC and average volume (AV) were lower in AMD patients with hypertension and ischaemic heart disease (IHD). The duration of hypertension was inversely correlated with ATC, AVC and AV (Rs = - 0.13, p < 0.05; Rs = - 0.12; p < 0.05, Rs = - 0.12; p < 0.05, respectively) while IHD duration negatively correlated with AV (Rs = - 0.15, p < 0.05). No such associations were observed in the control group. Our findings show that the choroidal vascular system in eyes with AMD is much more susceptible to damage in the presence than in the absence of systemic vascular disease.
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Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye 2021; 44:240-269. [DOI: 10.1016/j.clae.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
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7
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Nagasato D, Mitamura Y, Egawa M, Murao F, Nagasawa T, Komori N, Sonoda S, Sakamoto T, Tabuchi H. Changes in Choroidal Component Ratio and Circulation After Coffee Intake in Healthy Subjects. Invest Ophthalmol Vis Sci 2021; 62:27. [PMID: 33735377 PMCID: PMC7991961 DOI: 10.1167/iovs.62.3.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The effects of coffee intake on the ratio of stromal and luminal components in the choroid and the underlying mechanism remain unclear. This prospective cross-sectional study aimed to explore how coffee intake affects the choroidal component ratio and circulation. Methods Forty-nine right eyes of healthy adult volunteers were evaluated as the coffee intake group. Thirty-two right eyes of healthy volunteers served as the control group. The participants consumed 185 mL of coffee or water, respectively, and the systemic hemodynamics, enhanced-depth imaging optical coherence tomographic (EDI-OCT) images, and foveal mean blur rate (MBR), an indicator of blood flow velocity, were recorded at baseline and after coffee or water intake. The EDI-OCT images were binarized using ImageJ software, and subfoveal choroidal thickness (SCT) and whole, luminal, and stromal choroidal areas were calculated. Results In the coffee intake group, significant decreases in SCT and luminal area peaked at 60 minutes after intake (both P < 0.001), whereas a significant increase in MBR peaked at 30 minutes (P < 0.001). No significant stromal area fluctuations were observed. SCT and luminal area fluctuations exhibited a significant positive correlation (r = 0.978, P < 0.001). Significant negative correlations of luminal area fluctuations with MBR fluctuations were observed by stepwise regression analysis (r = -0.220, P < 0.001). The control group exhibited no significant fluctuations. Conclusions Coffee-induced choroidal thinning may result mainly from a reduction in the choroidal vessel lumen, and this vessel lumen reduction correlated with an increased choroidal blood flow velocity after coffee intake. These coffee-induced changes in choroidal component ratio and circulation should be considered when evaluating choroids.
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Affiliation(s)
- Daisuke Nagasato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.,Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Mariko Egawa
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Fumiko Murao
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshihiko Nagasawa
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.,Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Natsumi Komori
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.,Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
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8
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Li S, Pan Y, Xu J, Li X, Spiegel DP, Bao J, Chen H. Effects of physical exercise on macular vessel density and choroidal thickness in children. Sci Rep 2021; 11:2015. [PMID: 33479470 PMCID: PMC7820247 DOI: 10.1038/s41598-021-81770-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/11/2021] [Indexed: 11/09/2022] Open
Abstract
We used swept-source (SS) optical coherence tomography (OCT) and OCT angiography (OCTA) to investigate the effects of moderate physical exercise on retinal and choroidal vessel densities (VDs) and thicknesses in children. One eye in each of 40 myopic children (mean age, 11.70 years) and 18 emmetropic children (mean age, 11.06 years) were included. SS-OCT 6 × 6-mm radial scans and SS-OCTA 3 × 3-mm images were centered on the macula. Heart rate (HR), systolic and diastolic blood pressure, and intraocular pressure (IOP) were recorded before and immediately after a 20-min stationary cycling exercise and after a 30-min rest. The subfoveal choroidal thickness (SFCT), choroidal thickness (CT), and VD at the superficial and deep retinal layers, choriocapillaris, and deeper choroidal vessels were determined. SFCT and CT were significantly lower at all locations immediately after exercise (p < 0.001) and did not fully recover after rest (p < 0.05). VD was lower in the deep retinal layer after exercise (p = 0.02) and higher in the superficial layer after rest (p = 0.03) in myopic eyes while it was higher in the superficial (p < 0.01) and deep layer (p < 0.01) after rest in emmetropic eyes. No significant exercise-related changes in the superficial retinal VD, choroidal VD, or IOP were observed. ΔCT% and ΔSFCT% were significantly correlated with increases in HR in myopic group (p = 0.04 and p = 0.03, respectively). Exercise increased retinal VD after rest in emmetropic eyes, and caused significant CT thinning that lasted for at least 30 min in both emmetropic and myopic eyes.
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Affiliation(s)
- Shufeng Li
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Yiguo Pan
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Jingjing Xu
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Xue Li
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Daniel P Spiegel
- R&D Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Jinhua Bao
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
| | - Hao Chen
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
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Insa-Sánchez G, Fuentes-Broto L, Cobos A, Orduna Hospital E, Segura F, Sanchez-Cano A, Perdices L, Pinilla I. Choroidal Thickness and Volume Modifications Induced by Aerobic Exercise in Healthy Young Adults. Ophthalmic Res 2020; 64:604-612. [PMID: 33342973 DOI: 10.1159/000511201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Our aim was to evaluate the changes in choroidal thickness (CT) and volume (CV) following aerobic physical exercise in healthy young adults. METHODS This study included 72 eyes from healthy volunteers between 22 and 37 years old. Using the International Physical Activity Questionnaire, total physical activity was computed. Measurements using an autorefractometer, ocular biometry, and spectral-domain optical coherence tomography using the Enhanced Depth Imaging protocol were taken. OCT was performed as a baseline measurement and after performing 10 min of dynamic physical exercise (3 and 10 min post-exercise). The choroidal layer was manually segmented, and the CT and CV in different areas from the Early Treatment Diabetic Retinopathy Study grid were obtained. RESULTS In healthy adults, at 3 min post-exercise, CT was higher in the subfoveal, the 3-mm nasal, and the 6-mm superior areas. Between 3 and 10 min post-exercise, the CT was reduced in all areas, and in some areas, the values were even smaller than the baseline measurements. The CV values showed changes after exercise similar to those of thickness. The total CV recovery after exercise was related to sex and physical activity level. CONCLUSION Individuals with higher physical activity habits had greater CV at rest than those with lower physical activity levels. During exercise, healthy young people adjust CT and CV. At 3 min post-exercise, CT and CV increase. Women and individuals with greater physical activity levels reduce their total CV more than others during recovery.
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Affiliation(s)
- Gema Insa-Sánchez
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Pharmacology, Physiology and Legal and Forensic Medicine, Universidad de Zaragoza, Zaragoza, Spain
| | - Lorena Fuentes-Broto
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Pharmacology, Physiology and Legal and Forensic Medicine, Universidad de Zaragoza, Zaragoza, Spain
| | - Alberto Cobos
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Elvira Orduna Hospital
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain.,Department of Ophthalmology. Miguel Servet University Hospital, Zaragoza, Spain
| | - Francisco Segura
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain.,Department of Ophthalmology. Miguel Servet University Hospital, Zaragoza, Spain
| | - Ana Sanchez-Cano
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Lorena Perdices
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Isabel Pinilla
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Ophthalmology. Lozano Blesa University Hospital, Zaragoza, Spain.,Department of Surgery, Gynecology and Obstetrics, Universidad de Zaragoza, Zaragoza, Spain
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10
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Does Oxygen Uptake Before Physical Exercise Affect Tear Osmolarity? J Hum Kinet 2020; 73:297-304. [PMID: 32774560 PMCID: PMC7386152 DOI: 10.2478/hukin-2019-0118] [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] [Indexed: 11/20/2022] Open
Abstract
Recently, it has been reported that tear osmolarity (Tosm) is correlated with plasma osmolarity and will increase during exertion. We aimed to assess whether inhaling oxygen-enriched air between exercises could significantly change the Tosm value. Thirty men aged 24.9 years were included in the study. A cycloergometer was used to perform the exercise protocol. We recorded the participants’ Tosm (mOsm/L), heart rate (HR, beats/minute), oxygen saturation, and blood pressure values. After the first exhaustive exercise (T1), participants inhaled oxygen in the experimental group and a placebo in the control group. After the second exercise (T2), another set of measurements was obtained. The Tosm value before exercise was 297.4 ± 1.21 and 296.53 ± 1.11 mOsm/L (p = 0.61718) and the HR was 72.6 ± 2.59 and 73 ± 2.59 beats/minute (p = 0.39949) in the study and the control group, respectively. At T1, Tosm was 303.67 ± 1.25 and 302.2 ± 1.25 mOsm/L (p = 0.41286) and the HR reached 178.04 ± 2.60 and 176.4 ± 2.60 beats/minute (p = 0.65832), respectively. At T2, Tosm in the study group reached 305.73 ± 0.86 mOsm/L (correlation with the use of oxygen: r = −0.3818), and in the control group, it was 308.4 ± 0.86 mOsm/L (p = 0.0373), while the HR reached 172.20 ± 2.53 beats/minute in the study group and 178.2 ± 2.53 beats/minute in the control group (p = 0.057). It was concluded that inhaling oxygen before and after exercise could increase the rate of recovery after exhaustive exercise.
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11
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Mitamura Y, Enkhmaa T, Sano H, Niki M, Murao F, Egawa M, Sonoda S, Sakamoto T. Changes in choroidal structure following intravitreal aflibercept therapy for retinal vein occlusion. Br J Ophthalmol 2020; 105:704-710. [PMID: 32620686 PMCID: PMC8077220 DOI: 10.1136/bjophthalmol-2020-316214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/26/2020] [Accepted: 06/08/2020] [Indexed: 11/03/2022]
Abstract
AIMS To examine the choroidal change accompanying retinal vein occlusion (RVO) in detail, we measured changes in choroidal structure after intravitreal aflibercept (IVA) injections for RVO using binarisation of enhanced depth imaging optical coherence tomographic (EDI-OCT) images and assessed associations with clinical outcome. METHODS Retrospective, observational case series. Forty treatment-naïve patients (10 central, 18 major branch and 12 macular branch RVO) were examined by EDI-OCT before and 1, 3 and 6 months after IVA injections. EDI-OCT images were binarised using ImageJ. Subfoveal cross-sectional areas of the luminal, stromal and total choroid over a 1500 µm span were measured and the stromal area to total choroidal area (S/C) ratio was calculated. RESULTS Compared to normal contralateral eyes, afflicted eyes at baseline exhibited significantly greater stromal area (p<0.001), total choroidal area (p=0.001) and S/C ratio (p<0.001), but no difference in luminal area (p=0.083). The stromal area, S/C ratio and total choroidal area were significantly reduced in afflicted eyes at 1, 3 and 6 months after IVA (all p<0.006). Baseline S/C ratio was significantly correlated with baseline visual acuity (VA), baseline central retinal thickness (CRT) and VA and CRT improvement at 1, 3 and 6 months post-treatment even after adjusting for the axial length, age and sex (all p<0.012). CONCLUSION RVO induces substantial oedema of the choroidal stromal area that is detectable by binarisation of EDI-OCT images. This stromal oedema likely stems from high intraocular vascular endothelial growth factor levels. Changes in choroidal structure may be used to assess severity and prognosis of RVO.
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Affiliation(s)
- Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan .,Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan
| | - Tserennadmid Enkhmaa
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan
| | - Hiroki Sano
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan
| | - Masanori Niki
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan
| | - Fumiko Murao
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan
| | - Mariko Egawa
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan
| | - Shozo Sonoda
- Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan.,Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Japan Clinical Retina Study Group (J-CREST Group), Kagoshima, Japan.,Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Evaluation of microvascular changes in optic disc and retina by optical coherence tomography angiography during Valsalva maneuver. Int Ophthalmol 2020; 40:2743-2749. [PMID: 32533453 DOI: 10.1007/s10792-020-01461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Optical coherence tomography angiography (OCTA) is an increasingly widespread imaging tool that allows the visualization of the microvascular structures of the eye. It should be kept in mind in clinical practice, Valsalva maneuver (VM) may have an effect on OCTA findings. We aimed to evaluate the effect of VM on the optic nerve and retinal blood flow parameters measured by OCTA. METHODS Sixty age- and sex-matched healthy volunteers were included into this prospective study. Optic disc status for radial peripapillary capillary (RPC) network [whole image, inside disc and peripapillary capillary densities], superficial and deep capillary plexus whole, foveal, parafoveal and perifoveal densities and foveal avascular zone (FAZ) densities of volunteers were examined by OCTA both at rest and during VM. RESULTS The mean age of the subjects was 31.48 ± 7.49 (18-50) years and 51.7% were male. Superficial whole, parafoveal and perifoveal vessel densities were found to be significantly decreased during VM (p = 0.008, p= 0.015, p = 0.017, respectively). Lower levels of deep whole, parafoveal and perifoveal vessel densities were also detected while VM (p < 0.001 for all). However, there were no significant differences in terms of foveal vessel and FAZ densities. Additionally, VM significantly decreased RPC densities for whole image, inside and peripapillary capillary (p = 0.005, p < 0.001, p = 0.039, respectively). CONCLUSION VM may cause a significant decrease in optic nerve and para-perifoveal blood flow. Therefore, patient instruction about not holding breath is required before OCTA scanning.
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Burfield HJ, Carkeet A, Ostrin LA. Ocular and Systemic Diurnal Rhythms in Emmetropic and Myopic Adults. Invest Ophthalmol Vis Sci 2019; 60:2237-2247. [PMID: 31112608 PMCID: PMC6530516 DOI: 10.1167/iovs.19-26711] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate ocular and systemic diurnal rhythms in emmetropic and myopic adults and examine relationships with light exposure. Methods Adult subjects (n = 42, 22–41 years) underwent measurements every 4 hours for 24 hours, including blood pressure, heart rate, body temperature, intraocular pressure (IOP), ocular biometry, and optical coherence tomography imaging. Mean ocular perfusion pressure (MOPP) was calculated. Saliva was collected for melatonin and cortisol analysis. Acrophase and amplitude for each parameter were compared between refractive error groups. Subjects wore a light, sleep, and activity monitor for 1 week before measurements. Results All parameters exhibited significant diurnal rhythm (ANOVA, P < 0.05 for all). Choroidal thickness peaked at 2.42 hours, with a diurnal variation of 25.8 ± 13.44 μm. Axial length peaked at 12.96 hours, with a variation of 35.71 ± 6.6 μm. Melatonin peaked at 3.19 hours during the dark period, while cortisol peaked after light onset at 8.86 hours. IOP peaked at 11.24 hours, with a variation of 4.92 ± 1.57 mm Hg, in antiphase with MOPP, which peaked at 22.02 hours. Amplitudes of daily variations were not correlated with light exposure, and rhythms were not significantly different between emmetropes and myopes, except for body temperature and MOPP. Conclusions Diurnal variations in ocular and systemic parameters were observed in young adults; however, these variations were not associated with habitual light exposure. Emmetropic and myopic refractive error groups showed small but significant differences in body temperature and MOPP, while other ocular and systemic patterns were similar.
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Affiliation(s)
- Hannah J Burfield
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Andrew Carkeet
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
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Abstract
Physical exertion leads to the rise in tear osmolarity. However, previous studies have been conducted mostly on males and did not consider sex differences and the possible alteration in blinking during physical exercise. Sixteen women and 18 men aged 25.09 ± 1.70 were divided into equal groups with eyes open and shut. Participants performed 8-min medium-intensity exercise and 5-min intense exercise on a cycloergometer. Tear osmolarity (in mOsm/L) was evaluated before ( T0), after medium-intensity (T1) and intense exercise (T2). The blinking rate was assessed in a group with eyes open. Tear brake up time was measured in T0 and T1. With tear osmolarity measuring 305.72 ± 1.22 and 313.56 ± 1.90 for men and women, respectively, we observed significant differences in T1. In T2, tear osmolarity in men was 303.3 ± 1.28 vs. 310.87 ± 1.36 in women. The blinking rate decreased from 14.24 ± 2.54/min in T0 to 9.41 ± 2.83/min in T1. There was a statistically significant change in tear osmolarity in both groups, that is, in the group with eyes shut from 300.53 ± 1.37 in T0 to 308.06 ± 1.55 in T1 to 304.88 ± 1.54 in T2. In the group with eyes open, tear osmolarity increased from 300.29 ± 1.37 in T0 to 310.76 ± 1.55 in T1 and then dropped to 308.88 ± 1.54 in T2. Tear brake up time measured in T0 was 14.7 ± 1.43 vs. 13.53 ±1.48 in the open eyes condition. Due to physical exercise, short-term changes in tear osmolarity are partially caused by altered blinking. Sex differences in tear osmolarity in response to exertion may confirm the relationship between total body water and tear osmolarity.
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Nagasato D, Mitamura Y, Egawa M, Kameoka M, Nagasawa T, Tabuchi H, Kinoshita T, Sonoda S, Sakamoto T. Changes of choroidal structure and circulation after water drinking test in normal eyes. Graefes Arch Clin Exp Ophthalmol 2019; 257:2391-2399. [DOI: 10.1007/s00417-019-04427-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 11/28/2022] Open
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Kakiuchi N, Terasaki H, Sonoda S, Shiihara H, Yamashita T, Tomita M, Shinohara Y, Sakoguchi T, Iwata K, Sakamoto T. Regional Differences of Choroidal Structure Determined by Wide-Field Optical Coherence Tomography. ACTA ACUST UNITED AC 2019; 60:2614-2622. [DOI: 10.1167/iovs.18-24296] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Naoko Kakiuchi
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hideki Shiihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masatoshi Tomita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuki Shinohara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tomonori Sakoguchi
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuhiro Iwata
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Semi-automated software to measure luminal and stromal areas of choroid in optical coherence tomographic images. Jpn J Ophthalmol 2017; 62:179-185. [PMID: 29270813 DOI: 10.1007/s10384-017-0558-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/14/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE To determine the capabilities of "EyeGround" software in measuring the choroidal cross sectional areas in optical coherence tomographic (OCT) images. STUDY DESIGN Cross sectional, prospective study. METHODS The cross-sectional area of the subfoveal choroid within a 1500 µm diameter circle centered on the fovea was measured both with and without using the EyeGround software in the OCT images. The differences between the evaluation times and the results of the measurements were compared. The inter-rater, intra-rater, inter-method agreements were determined. RESULTS Fifty-one eyes of 51 healthy subjects were studied: 24 men and 27 women with an average age of 35.0 ± 8.8 years. The time for analyzing a single image was significantly shorter with the software at 3.2±1.1 min than without the software at 12.1±5.1 min (P <0.001). The inter-method correlation efficient for the measurements of the whole choroid was high [0.989, 95% CI (0.981-0.994)]. With the software, the inter-rater correlation efficient was significantly high [0.997, 95% CI (0.995-0.999)], and the intra-rater correlation efficient was also significantly high [0.999, 95% CI (0.999-1.0)]. CONCLUSION The EyeGround software can measure the choroidal area in the OCT cross sectional images with good reproducibility and in a significantly shorter times. It can be a valuable tool for analyzing the choroid.
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Zhang X, Cole E, Pillar A, Lane M, Waheed N, Adhi M, Magder L, Quigley H, Saeedi O. The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes. Invest Ophthalmol Vis Sci 2017; 58:3278-3285. [PMID: 28666278 PMCID: PMC5493330 DOI: 10.1167/iovs.17-21598] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/08/2017] [Indexed: 01/22/2023] Open
Abstract
Purpose Choroidal thickness increases linearly with intraocular pressure (IOP) lowering. We studied the relationship between the change in size of the choroidal vasculature and IOP lowering after glaucoma procedures. Methods Thirty eyes of twenty-nine patients were examined pre- and postoperatively for up to 6 months with standard clinical assessment, enhanced depth imaging spectral-domain optical coherence tomography (OCT), and axial length measurement. Each enhanced depth imaging spectral-domain OCT image was analyzed using three separate methods to determine the choroidal thickness, choroidal vessel thickness, choroidal interstitial thickness, large choroidal vessel layer thickness, medium choroidal vessel layer thickness, and light-dark ratio. Bivariate linear regression analysis was completed with largest change in IOP as the independent variable. The dependent variables included choroidal thickness, choroidal vessel thickness, and choroidal interstitial thickness, at the largest change in IOP. Multivariable regression analysis using a generalized estimating equation to account for multiple measurements per eye was also completed. Results Mean choroidal vessel thickness increases 1.5 μm for every 1 mm Hg decrease in IOP (P < 0.0001; 95% confidence interval [CI], 0.8, 2.1) and choroidal interstitial thickness increases 1.3 μm for every 1 mm Hg change in IOP (P < 0.0001; 95% CI, 0.8, 1.8). There was no significant association between change in IOP and change in large choroidal vessel layer temporally (P = 0.13), nasally (P = 0.20), or subfoveally (P = 0.18). There was also no association between IOP and the light-dark ratio (P = 0.16). Conclusions The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.
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Affiliation(s)
- Xuemin Zhang
- Medstar Harbor Hospital, Baltimore, Maryland, United States
| | - Emily Cole
- Tufts University School of Medicine, Boston, Massachusetts, United States
| | - Angelique Pillar
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Mark Lane
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Nadia Waheed
- New England Eye Center/Tufts University School of Medicine, Boston, Massachusetts, United States
| | - Mehreen Adhi
- Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, Kentucky, United States
| | - Laurence Magder
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Harry Quigley
- Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | - Osamah Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States
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