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Genç ÇD, Yılmaz AK, Kurt MM, Özgür G, Aydın E, Yılmaz C. Comparison of choroidal thickness, superficial and deep retinal vascular indices, and foveal avascular zones: Martial arts athletes vs healthy non-athletes. Photodiagnosis Photodyn Ther 2024; 48:104266. [PMID: 38977118 DOI: 10.1016/j.pdpdt.2024.104266] [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: 05/07/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024]
Abstract
AIM The study aims to compare choroidal thickness, deep and superficial retinal capillary plexuses, and foveal avascular zone (FAZ) parameters in elite martial arts athletes and a healthy sedentary control group. METHODS The study included martial arts athletes (32 individuals, 64 eyes) and healthy sedentary persons (43 individuals with healthy sedentary lifestyles, 86 eyes) aged 18-35 years. In this single non-repeated observational and cross-sectional study, choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ measurements were measured using Swept-source optical coherence tomography angiography (SS-OCTA) and compared between groups. RESULTS No statistically significant differences were found (p > 0.05) in age, IOP, AL (axial length), and best-corrected visual acuity (BCVA) parameters between groups. There were no statistically significant differences between the groups in choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ parameters determined by the OCTA method (p > 0.05). CONCLUSION In our study, we observed that the retinal and choroidal structures of martial art athletes and healthy sedentary individuals were similar. This observation implies that the putative microvascular effects on the choroid and retina in martial arts, especially those based on the anaerobic energy system, may reflect similar outcomes to those observed in individuals with sedentary lifestyles characterized by healthiness.
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Affiliation(s)
- Çiğdem Deniz Genç
- Department of Ophthalmology, Samsun University, Faculty of Medicine, Samsun, Turkey, 55090
| | - Ali Kerim Yılmaz
- Department of Recreation, Ondokuz Mayıs University, Faculty of Sport Sciences, Samsun, Türkiye, 55200.
| | - Muhammed Mustafa Kurt
- Department of Ophthalmology, Samsun University, Faculty of Medicine, Samsun, Turkey, 55090
| | - Gökhan Özgür
- Department of Ophthalmology, Samsun University, Faculty of Medicine, Samsun, Turkey, 55090
| | - Emre Aydın
- Department of Ophthalmology, Samsun University, Faculty of Medicine, Samsun, Turkey, 55090
| | - Coşkun Yılmaz
- Kelkit Aydın Doğan Vocational School, Gümüşhane University, Kelkit/Gümüşhane, 29600, Türkiye
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Nelis P, Nieweler A, Brücher V, Eter N, Ten Tusscher M, Alnawaiseh M. Light conditions influence optic nerve OCT angiography parameter in healthy subjects with neutral pupils. Sci Rep 2023; 13:9154. [PMID: 37280254 DOI: 10.1038/s41598-023-36069-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 05/29/2023] [Indexed: 06/08/2023] Open
Abstract
Optical coherence tomography angiography measurements are influenced by a range of environmental factors as blood pressure and physical fitness. The present study aimed to evaluate the effects of light and dark exposure in eyes with neutral and mydriatic pupils on vessel density in the macular and optic nerve head regions, as measured using optical coherence tomography angiography (OCTA). 55 eyes of 55 healthy volunteers (28 patients with neutral pupils; 27.18 ± 4.33 years) were examined using a high-speed and high-resolution spectral-domain OCT XR Avanti system with a split-spectrum amplitude de-correlation angiography algorithm. OCTA imaging was performed after dark adaptation and after exposure to light. The vessel density data of the superficial and deep retinal macular and optic nerve head region OCT-angiogram were analyzed for these two light conditions. Through Bonferroni correction for multiple testing, the p- value was adapted from 0.05 to 0.017. In eyes with neutral pupils, a significant increase was found in the capillary region of the optic nerve head region (p = 0.002), comparing dark- and light-adaptation. In the macular region of eyes with neutral (p = 0.718) and mydriatic pupils (p = 0.043), no significant differences were observed, as were any in the optic nerve head region of the mydriatic eyes (p = 0.797). This observation suggests that light conditions could be a possible factor influencing OCTA measurements. After dark exposure, vessel density data were significantly different between eyes with neutral and mydriatic pupils (nerve head region: p < 0.0001, superficial macula: p < 0.0001, deep macula: p = 0.0025). These data warn for the effect of mydriatic drops on vessel density measurements.
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Affiliation(s)
- Pieter Nelis
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany.
- Department of Ophthalmology, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Ophthalmology, Helios Augenklinik Berlin-Buch, Berlin-Buch, Germany.
| | - A Nieweler
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - V Brücher
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - N Eter
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - M Ten Tusscher
- Department of Ophthalmology, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Alnawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
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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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Leclaire MD, Eter N, Alnawaiseh M. [Optical coherence tomography angiography and cardiovascular diseases. An overview of the current knowledge]. Ophthalmologe 2021; 118:1119-1127. [PMID: 33616736 PMCID: PMC8568759 DOI: 10.1007/s00347-021-01336-1] [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: 11/09/2020] [Revised: 12/23/2020] [Accepted: 01/26/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading cause of death worldwide. The observability of retinal vessel changes in the context of CVD by funduscopy has been known for a long time. Optical coherence tomography angiography (OCTA) is a novel technique for noninvasive detailed imaging and quantification of the retinal microcirculation. The OCTA enables the visualization of vascular changes in a simple and well-reproducible way. Its applications are not limited to the field of ophthalmology. In recent years, several experimental and clinical studies have been published on vascular changes detectable with OCTA in CVD. This review summarizes the most important findings of these studies. METHODS This work is based on a comprehensive review of the literature and on the presentation of own data. RESULTS Nowadays, OCTA studies are available for many diseases of the cardiovascular spectrum. This indicates that systemic vascular diseases are associated with changes in the retinal microcirculation. These changes can be visualized and reproducibly quantified with OCTA. In many diseases subclinical changes, which are detectable by OCTA, occur before the underlying disease causes otherwise measurable changes or noticeable symptoms for the patient. CONCLUSION The OCTA is a promising imaging method in the context of CVD in both scientific and clinical applications. It can be used for the diagnostics and quantification of retinal vascular changes. Further studies will show whether OCTA can be of assistance in the estimation of individual systemic cardiovascular risk profiles.
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Affiliation(s)
- Martin Dominik Leclaire
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland.
| | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Maged Alnawaiseh
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
- Klinik für Augenheilkunde, Klinikum Fulda, Universitätsmedizin Marburg - Campus Fulda, Fulda, Deutschland
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Fang M, Strand K, Zhang J, Totillo M, Signorile JF, Galvin JE, Wang J, Jiang H. Retinal vessel density correlates with cognitive function in older adults. Exp Gerontol 2021; 152:111433. [PMID: 34091000 DOI: 10.1016/j.exger.2021.111433] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/09/2021] [Accepted: 05/28/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE We examined the associations between retinal microvascular density, cognition, and physical fitness in healthy older adults with no reported cognitive decline. METHODS Twenty cognitively normal older adults (age: 70.3 ± 4.6 years) were recruited. Both eyes of each subject were imaged using optical coherence tomography angiography. The vessel densities of the retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP) were measured. Cognitive function was assessed using the Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA), while physical performance was evaluated using the total work during the YMCA cycle ergometer test (TW-YMCA). Spearman correlations (rs) were computed between measures of retinal microvascular density, cognitive function, and physical performance. RESULTS The MoCA was significantly correlated to vessel density of SVD (rs = 0.53, P = 0.02) but not RVN (rs = 0.39, P = 0.09) and DVP (rs = 0.02, P = 0.93). MoCA was not correlated with TW-YMCA (rs = 0.05, P = 0.83). Retinal microvascular densities were not related to TW-YMCA (rs = -0.05-0.18, P > 0.05). Additionally, MMSE was not related the retinal vessel densities (rs = -0.10-0.21, P > 0.05) and TW-YMCA (rs = -0.19, P = 0.41). CONCLUSIONS This is the first study to reveal the association between retinal vessel density and cognition as measured with MoCA in healthy older adults with no reported cognitive decline.
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Affiliation(s)
- Min Fang
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, China; Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keri Strand
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - Juan Zhang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Matthew Totillo
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - Joseph F Signorile
- Department of Kinesiology and Sports Sciences, University of Miami, FL, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, 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; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
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Fasolino G, Awada G, Koulalis JS, Neyns B, Van Elderen P, Kuijpers RW, Nelis P, Ten Tusscher M. Choriocapillaris Assessment In Patients Under Mek-Inhibitor Therapy For Cutaneous Melanoma: An Optical Coherence Tomography Angiography Study. Semin Ophthalmol 2021; 36:765-771. [PMID: 33755528 DOI: 10.1080/08820538.2021.1903512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The present study investigates by optical coherence tomography angiography (OCTA) the retinal capillary plexus and choriocapillaris flow voids and their possible correlation with MEKAR. METHODS 34 eyes of 17 patients (61.5 years [30.4-77.4]) with stage IV cutaneous melanoma were included prospectively. All patients showed disease progression under treatment with Nivolumab/Ipilimumab and were subsequently treated with the MEK-inhibitor Trametinib 2 mg once daily. At the start and every 6 weeks during follow-up of 4 months, patients underwent a complete ophthalmologic exam, OCTA and when needed fluorescein angiography. RESULTS Statistical analysis was performed on 17 eyes of 9 patients. Eight patients were excluded due to missing OCTA images or due to drop-out because of decease or change of treatment. Comparing vessel area density (P = .625 and 0.681, respectively), vessel skeleton density (P = .996 and 0.766, respectively) of the superficial and deep capillary plexus, flow void number and total flow void area (mm2 and %) (P = .495; 0.197 and 0.298, respectively) of choriocapillaris slab, before and after treatment, revealed no significant difference. The evolution of choriocapillaris flow void parameter did not significantly differ in patients, who developed MEKAR compared to patients who did not. CONCLUSION In patients receiving MEK-inhibitor with and without MEKAR, no significant different characteristics of the retinal capillary plexus and choriocapillaris were found. These data suggest that the development of MEKAR, has no correlation with vascular alteration.
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Affiliation(s)
- Giuseppe Fasolino
- Department of Ophthalmology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Gil Awada
- Department of Oncology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Bart Neyns
- Department of Oncology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Van Elderen
- Department of Ophthalmology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Robert W Kuijpers
- Department of Ophthalmology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Pieter Nelis
- Department of Ophthalmology, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
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Alten F, Eter N, Schmitz B. Differential effects of high-intensity interval training (HIIT) on choriocapillaris perfusion in healthy adults and patients with type 1 diabetes mellitus (T1DM). Microvasc Res 2021; 135:104128. [PMID: 33417915 DOI: 10.1016/j.mvr.2020.104128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/27/2020] [Accepted: 12/26/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the effects of a four-week high-intensity interval training (HIIT) on choriocapillaris (CC) perfusion in young healthy adults and type 1 diabetes mellitus (T1DM) patients. METHODS Data of two HIIT studies with baseline to follow-up comparison were retrospectively analysed. Twenty healthy participants and twenty T1DM patients without clinical signs of diabetic retinopathy were included. All participants had performed a four-week all-out HIIT protocol with a total of 8 training sessions. Changes in physical fitness were assessed using power output at the individual aerobic lactate threshold (IANT). Optical coherence tomography angiography (OCTA) imaging was performed at baseline and follow-up. CC images were analysed for number, size and total area of flow deficits (FD), mean signal intensity, signal intensity standard deviation and kurtosis of signal intensity distribution. RESULTS At baseline, CC OCTA revealed a lower and more heterogeneous intensity signal in T1DM eyes (mean intensity signal and standard deviation of signal intensity, p < 0.001). Percent of CC FD area was greater in T1DM eyes (p < 0.001). While T1DM patients showed greater improvement of exercise capacity at IANT than healthy controls (group×time p = 0.0403), CC FD area and standard deviation of intensity increased in healthy controls but not in T1DM patients (group×time p ≤ 0.029). Moreover, linear regression slopes of FD region distribution differed significantly at baseline and follow-up (p = 0.0002) in healthy individuals but not in T1DM patients. CONCLUSIONS Effects of regular physical exercise performed as HIIT on CC perfusion were only seen in healthy participants, not in T1DM patients suggesting impaired CC adaptation in T1DM.
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Affiliation(s)
- Florian Alten
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - Boris Schmitz
- Institute of Sports Sciences, University of Muenster, Muenster, Germany
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