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Badian RA. Schematic sectioning approaches for corneal and retinal surfaces used in ophthalmology and vision-related clinical practice and research. Exp Eye Res 2023; 230:109442. [PMID: 36940902 DOI: 10.1016/j.exer.2023.109442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023]
Abstract
Schematically, the corneal surface area and other similar surfaces such as the retinal surface and the visual field area have been represented by a circle. While there are different types of schematic sectioning patterns in use, not all patterns are recognized or referred to with their respective appropriate terminology. In scientific communications, as well as in clinical practice, when dealing with corneal or retinal surfaces, it is imperative to have the ability to refer to specific areas with an as high degree of accuracy as possible. The necessity arises in many situations, either when performing tests such as corneal surface staining, corneal sensitivity test, scanning the corneal surface, reporting of the findings related to any specific corneal surface area, or using a sectioning pattern for parts of the retinal surface when locating retinal lesions, or when referring to loci with changes in the visual field. Applying the appropriate geometric terms when any pattern is used for sectioning of surfaces such as cornea or retina, for precise localization and description of the findings or changes with a high degree of accuracy using the correct terminology is a sine qua non. Hence, the idea for this work is to gain an overview of the sectioning methods that are available and in use as methodological guidance in different sectioning patterns related to the corneal, retinal, and visual field.
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Affiliation(s)
- Reza A Badian
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
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2
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Deng Y, Wang H, Simms AG, Hu H, Zhang J, Gameiro GR, Rundek T, Signorile JF, Levin BE, Yuan J, Wang J, Jiang H. Age-related focal thinning of the ganglion cell-inner plexiform layer in a healthy population. Quant Imaging Med Surg 2022; 12:3034-3048. [PMID: 35655824 PMCID: PMC9131335 DOI: 10.21037/qims-21-860] [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: 09/09/2021] [Accepted: 03/11/2022] [Indexed: 02/03/2023]
Abstract
Background Given the aging of the population worldwide, to learn the underlying age-related biological phenomena is important to improve the understanding of the ageing process. Neurodegeneration is an age-associated progressive deterioration of the neuron. Retinal neurodegeneration during aging, such as the reduction in thickness of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) measured by optical coherence tomography (OCT), has been reported, but no studies have provided their specific alteration patterns with age. Therefore, this study is to provide visualization of the evolution of various tomographic intraretinal layer thicknesses during aging and to document age-related changes in focal thickness. Methods A total 194 healthy subjects were included in this cross-sectional study. The subjects were divided into four age groups: G1, <35 years; G2, 35-49 years; G3, 50-64 years; and G4 ≥65 years. One eye of each subject was imaged using a custom-built ultrahigh-resolution optical coherence tomography (UHR-OCT). Volumetric data centered on the fovea were segmented to obtain the thickness maps of six intraretinal layers, including the macular retinal nerve fiber layer (mRNFL) and GCIPL. Results There were alterations visualized in thickness maps in these intraretinal layers. The GCIPL showed a thickness reduction localized in the inner annulus in elder subjects (G4). Within the inner annulus, the most profound alteration in G4, an oval zone (length 0.76 mm and width 0.52 mm), appeared to be in the inferior sector about 0.61 mm below the fovea, named "A zone". The average thickness reduction of the A zone was 14.4 µm in the elderly group (G4). Age was significantly related to the GCIPL thickness of the inner annulus (ρ =-0.48; P<0.001) and of the A zone (ρ =-0.39, P<0.001). Conclusions This is the first study to apply UHR-OCT for visualizing the age-related alteration of intraretinal layers in a general population. The most profound change of the optic nerve fiber is an oval-like focal thinning in GCIPL, which occurred in the inferior sector within the inner annulus and was strongly related to increased age.
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Affiliation(s)
- Yuqing Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;,Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Huijuan Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA;,Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ava-Gaye Simms
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Huiling Hu
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA;,Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Juan Zhang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA;,School of Ophthalmology and Optometry, School of Biomedical Engieering, Wenzhou Medical University, Wenzhou, China
| | - Giovana Rosa Gameiro
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tatjana Rundek
- Department of Neurology, The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joseph F. Signorile
- Max Orovitz Laboratory, University of Miami, Coral Gables, FL, USA;,Center on Aging, University of Miami, School of Medicine, Miami, FL, USA
| | - Bonnie E. Levin
- Department of Neurology, The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;,Department of Ophthalmology, Bascom Palmer Eye Institute, 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, The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Alex V, Motevasseli T, Freeman WR, Jayamon JA, Bartsch DUG, Borooah S. Assessing the validity of a cross-platform retinal image segmentation tool in normal and diseased retina. Sci Rep 2021; 11:21784. [PMID: 34750415 PMCID: PMC8575997 DOI: 10.1038/s41598-021-01105-9] [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: 04/06/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022] Open
Abstract
Comparing automated retinal layer segmentation using proprietary software (Heidelberg Spectralis HRA + OCT) and cross-platform Optical Coherence Tomography (OCT) segmentation software (Orion). Image segmentations of normal and diseased (iAMD, DME) eyes were performed using both softwares and then compared to the 'gold standard' of manual segmentation. A qualitative assessment and quantitative (layer volume) comparison of segmentations were performed. Segmented images from the two softwares were graded by two masked graders and in cases with difference, a senior retina specialist made a final independent decisive grading. Cross-platform software was significantly better than the proprietary software in the segmentation of NFL and INL layers in Normal eyes. It generated significantly better segmentation only for NFL in iAMD and for INL and OPL layers in DME eyes. In normal eyes, all retinal layer volumes calculated by the two softwares were moderate-strongly correlated except OUTLY. In iAMD eyes, GCIPL, INL, ONL, INLY, TRV layer volumes were moderate-strongly correlated between softwares. In eyes with DME, all layer volume values were moderate-strongly correlated between softwares. Cross-platform software can be used reliably in research settings to study the retinal layers as it compares well against manual segmentation and the commonly used proprietary software for both normal and diseased eyes.
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Affiliation(s)
- Varsha Alex
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Tahmineh Motevasseli
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - William R Freeman
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | | | - Dirk-Uwe G Bartsch
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA
| | - Shyamanga Borooah
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92093, USA.
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Chen Q, Jiang H, Delgado S, Hernandez J, Alba DE, Gregori G, Rammohan KW, Porciatti V, Wang J. Longitudinal Study of Retinal Structure, Vascular, and Neuronal Function in Patients With Relapsing-Remitting Multiple Sclerosis: 1-Year Follow-Up. Transl Vis Sci Technol 2021; 10:6. [PMID: 34111252 PMCID: PMC8107487 DOI: 10.1167/tvst.10.6.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objective The purpose of this study was to quantify retinal structural, vascular, and functional changes in patients with relapsing-remitting multiple sclerosis (RRMS) over 1 year. Methods Eighty-eight eyes of 44 patients with RRMS underwent assessments of low contrast letter acuity (LCLA), retinal ganglion cell function detected by the steady-state pattern electroretinogram (PERG), axonal microstructural integrity measured as birefringence, intraretinal layer thicknesses by ultra-high-resolution optical coherence tomography (OCT), volumetric vessel density (VVD) by OCT angiography, and retinal tissue perfusion (RTP) by the Retinal Function Imager (RFI). All measurements were performed at baseline and 1-year follow-up. The impacts of disease activities and a history of optic neuritis (ON) were analyzed. Results Compared to baseline, there were no significant differences in all variables (P > 0.05), except for the axonal birefringence and RTP. The birefringence's of the retinal fiber layer at the temporal and superior quadrants was significantly decreased (P < 0.05), whereas RTP was significantly increased (P < 0.05). In the subgroup with ON, significantly longer PERG latency and decreased VVD were observed at follow-up (P < 0.05). In patients with improved LCLA, significantly increased RTP and decreased VVD (P < 0.05) were also observed. Conclusions This is the first longitudinal study that assessed the RTP and VVD, along with other retinal structural and functional parameters in MS. The recovery of retinal vascular function occurred with the improved LCLA, suggesting that these measurements may be associated with disease progression. Translational Relevance The retinal microvascular changes could be potential biomarkers for monitoring therapeutic efficacy in MS.
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Affiliation(s)
- Qi Chen
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, China,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
| | - Silvia Delgado
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeffrey Hernandez
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Diego Eduardo Alba
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovanni Gregori
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kottil W. Rammohan
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Vittorio Porciatti
- Department of Ophthalmology, Bascom Palmer Eye Institute, 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
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Jiang H, Gameiro GR, Hu H, Monsalve PF, Dong C, Hernandez J, Delgado SR, Porciatti VD, Wang J. Shortened Pattern Electroretinogram Latency and Impaired Autoregulatory Dynamics to Steady-State Stimuli in Patients With Multiple Sclerosis. J Neuroophthalmol 2021; 41:60-68. [PMID: 31977664 DOI: 10.1097/wno.0000000000000894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The steady-state pattern electroretinogram (PERG) is a sensitive measure of retinal ganglion cell (RGC) function that includes within-test progressive changes-adaptation-reflecting RGC autoregulatory dynamics. Comprehensive PERG assessment in patients with multiple sclerosis (MS) (with or without optic neuritis [ON]) may provide unique information about RGC dysfunction and its progression, as well as a comparison between functional loss and structural loss as measured by optical coherence tomography (OCT). The goal of this project was to measure steady-state PERG components and their associations with intraretinal layer thicknesses in MS. METHODS One hundred forty eyes of 70 patients with relapsing-remitting MS and 126 eyes of 63 age- and sex-matched healthy control subjects (HC) were investigated using a new-generation PERG method and ultrahigh-resolution OCT. Of MS eyes, there were 30 eyes with ON (MSON), 22 non-ON fellow eyes (MSFE), and 88 non-ON MS eyes (MSNON). PERG amplitude, phase (latency), and adaptation of amplitude and phase were measured and correlated with OCT-determined thicknesses of intraretinal layers. RESULTS The average PERG amplitude in MSON eyes was significantly lower than MSFE (P = 0.007), MSNON (P = 0.002), and HC (P < 0.001). The PERG amplitude in MSFE eyes was also significantly lower than HC (P = 0.039). The PERG latency in MSON eyes was significantly shorter than in MSFE (P = 0.001), MSNON (P = 0.002), and HC (P < 0.001). The PERG latency in MSFE (P = 0.007) and MSNON (P = 0.002) was significantly shorter than in HC. However, no significant differences were found between MSFE and MSNON (P > 0.05). PERG adaptation of amplitude in MSON was significantly lower than that in MSNON (P = 0.039) and HC (P = 0.037). Both the amplitude and latency in the MS eyes were significantly correlated with the thicknesses of the macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GCIPL). CONCLUSIONS Shortened PERG latency and impaired autoregulatory dynamics occurred in MS, suggesting preferential dysfunction of small, slower RGC axons and decreased ability of RGC to autoregulate their gain in response to PERG stimulus. The established relations of PERG measurements with intraretinal thickness measurements suggested that PERG losses were primarily associated with GCIPL and mRNFL thinning.
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Affiliation(s)
- Hong Jiang
- Department of Ophthalmology (HJ, GRG, HH, PFM, VDP, JW), Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida; Department of Neurology (HJ, CD, JH, SRD), University of Miami, Miller School of Medicine, Miami, Florida; and Department of Ophthalmology (HH), Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
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Jiang H, Delgado S, Wang J. Advances in ophthalmic structural and functional measures in multiple sclerosis: do the potential ocular biomarkers meet the unmet needs? Curr Opin Neurol 2021; 34:97-107. [PMID: 33278142 PMCID: PMC7856092 DOI: 10.1097/wco.0000000000000897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE OF REVIEW Multiple sclerosis is a heterogeneous disorder. Biomarkers to monitor disease activities are highly desirable especially because of the recent shift toward personalized medicine that coincides with the expansion of disease-modifying therapy. The visual system is highly involved in multiple sclerosis, and the rapid advancement of ophthalmic techniques has boosted the development of potential ocular biomarkers for multiple sclerosis management. RECENT FINDINGS Recent studies have found that the rapid thinning of the peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer (GCIPL) occurs in the progressive stage. Furthermore, the inter-eye thickness difference of the GCIPL could be used in identifying unilateral optic neuritis to facilitate the early diagnosis of multiple sclerosis. Moreover, the retinal microvascular alterations measured as vessel density were found to be related to the disability and visual function, although a standardized protocol to measure retinal microvascular alterations has not been well established. Additionally, aberrant ocular motility, such as fixation microsaccades, can be used to measure disability objectively. SUMMARY The fast expansion of potential ocular biomarkers measured as retinal microstructural, microvascular, and ocular motility changes may facilitate the diagnosis and management of multiple sclerosis.
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Affiliation(s)
- 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
| | - Silvia Delgado
- 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
- Department of Electrical and Computer Engineering, University of Miami, Miami, FL, USA
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Maharshak I, Hecht I, Mankuta L, Achiron A, Spierer O, Burgansky Z, Bar A, Grossbard A, Katkov A, Cernes R, Feldman L. The effect of hemodialysis on individual retinal layer thickness. Int Ophthalmol 2021; 41:1233-1240. [PMID: 33389423 DOI: 10.1007/s10792-020-01677-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to employ newly developed advanced image analysis software to evaluate changes in retinal layer thickness following hemodialysis. METHODS A non-randomized prospective study of patients with end-stage renal disease assessed on the same day before and after hemodialysis. Intraocular pressure and central corneal thickness were analyzed, and spectral domain optical coherence tomography results were automatically segmented using the Orion software and then compared. All patients had normal retinal optical coherence tomography findings before hemodialysis. RESULTS Of the 31 suitable end-stage renal disease patients treated with hemodialysis who provided consent to participate, seven were unable to complete all evaluations, leaving 24 patients for analysis in the final study group. Their mean age was 66.67±14.3 years (range: 35-88), and 62.5% were males. Mean central corneal thickness did not change following hemodialysis (563.4±30.2 µm to 553.1±47.2 µm, p=.247), while mean intraocular pressure decreased (14.48±2.5 mmHg to 13.16±2.28 mmHg, p=.028). Individual mean retinal layer thickness showed no significant change, including the retinal nerve fiber layer (40.9±6.8 µm to 40.1±5.2 µm, p=.412), the ganglion cell and the inner plexiform layer (68.66±8 µm to 69.03±7.6 µm, p=.639), and the photoreceptor layer (50.26±2.8 µm to 50.32±3.1 µm, p=.869). Total retinal thickness similarly remained constant, with a mean of 303.7±17.3 µm before and 304.33±18.4 µm after hemodialysis (p=.571). CONCLUSIONS Thickness of retinal layers, as assessed by individual segmentation, and central corneal thickness were not affected by hemodialysis treatment, while intraocular pressure was significantly reduced among patients with end-stage renal disease without pre-existing ocular pathology who were undergoing hemodialysis. These results support the view that hemodialysis does not have a negative impact on the retinal morphology of end-stage renal disease patients, who comprise a population with high rates of diabetic and/or hypertensive retinopathy as well as vision-threatening complications.
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Affiliation(s)
- Idit Maharshak
- Department of Ophthalmology, Edith Wolfson Medical Center, 62 Halochamim St, Holon, Israel. .,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Idan Hecht
- Department of Ophthalmology, Shamir Medical Center, Beer Yaakov, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Lihi Mankuta
- Department of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Asaf Achiron
- Department of Ophthalmology, Edith Wolfson Medical Center, 62 Halochamim St, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Oriel Spierer
- Department of Ophthalmology, Edith Wolfson Medical Center, 62 Halochamim St, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Zvia Burgansky
- Department of Ophthalmology, Meir medical center, Kefar Sava, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Asaf Bar
- Department of Ophthalmology, Edith Wolfson Medical Center, 62 Halochamim St, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Aliza Grossbard
- Department of Nephrology and Hypertension, Edith Wolfson Medical Center, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Anna Katkov
- Department of Nephrology and Hypertension, Edith Wolfson Medical Center, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Relu Cernes
- Department of Nephrology and Hypertension, Edith Wolfson Medical Center, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Leonid Feldman
- Department of Nephrology and Hypertension, Edith Wolfson Medical Center, Holon, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Lamin A, Jarrar Z, Williams KM, Garg A, Basheer K, Sivaprasad S, Hammond CJ, Mahroo OA. Segmented Macular Layer Volumes from Spectral Domain Optical Coherence Tomography in 184 Adult Twins: Associations With Age and Heritability. Invest Ophthalmol Vis Sci 2020; 61:44. [PMID: 32446249 PMCID: PMC7405717 DOI: 10.1167/iovs.61.5.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate segmented macular layer volumes from a healthy adult twin cohort (TwinsUK), exploring changes with age and heritability. Methods Macular spectral domain optical coherence tomography images were acquired from monozygotic (MZ) and dizygotic (DZ) twins in a cross-sectional study. The following layer volumes were derived for circles of 3 and 6 mm diameter around the foveal center, using automated segmentation software: retinal nerve fiber layer (RNFL), ganglion cell–inner plexiform layer (GCIPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptors (PR), retinal pigment epithelium (RPE), and total retinal volume (TRV). Correlation coefficients (intereye; age; intrapair for MZ and DZ pairs) were quantified; heritability was estimated using structural equation modeling. Results Scans from 184 participants were included. Intereye correlation was highest for TRV and GCIPL. Negative correlations with age (for 3- or 6-mm areas, or both) were observed for TRV, RNFL, GCIPL, and INL. Positive correlations were observed for PR, RPE, and OPL. For all layers, intrapair correlation was greater for MZ than DZ pairs. Heritability estimates were highest (>80%) for TRV and GCIPL volume, and lowest for RPE volume. Conclusions Although TRV was negatively correlated with age, all layers did not show negative correlation. Some inner layers thinned with age, whereas some outer volumes increased (not the ONL). Reduced RPE phagocytic function with age and remodeling in the OPL could be contributing factors. Heritability estimates were highest for inner retinal layers (particularly GCIPL), and lowest for RPE volume.
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Airen S, Shi C, Liu Z, Levin BE, Signorile JF, Wang J, Jiang H. Focal alteration of the intraretinal layers in neurodegenerative disorders. ACTA ACUST UNITED AC 2020; 5. [PMID: 32939442 DOI: 10.21037/aes.2019.12.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Focal intraretinal alterations have been studied to advance our understanding of the pathology of neurodegenerative diseases. The current literature involving focal alterations in the intraretinal layers was reviewed through PubMed using the search terms "focal alteration", "region of interest", "optical coherence tomography", "glaucoma", "multiple sclerosis", "Alzheimer's disease", "Parkinson disease", "neurodegenerative diseases" and other related items. It was found that focal alterations of intraretinal layers were different in various neurodegenerative diseases. The typical focal thinning might help differentiate various ocular and cerebral diseases, track disease progression, and evaluate the outcome of clinical trials. Advanced exploration of focal intraretinal alterations will help to further validate their clinical and research utility.
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Affiliation(s)
- Shriya Airen
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ce Shi
- 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 325000, China
| | - Zhiping Liu
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,Ophthalmic Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China
| | - Bonnie E Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joseph F Signorile
- Department of Kinesiology and Sports Sciences, University of 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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Hu H, Jiang H, Gameiro GR, Hernandez J, Delgado S, Wang J. Focal Thickness Reduction of the Ganglion Cell-Inner Plexiform Layer Best Discriminates Prior Optic Neuritis in Patients With Multiple Sclerosis. Invest Ophthalmol Vis Sci 2020; 60:4257-4269. [PMID: 31618762 PMCID: PMC6996667 DOI: 10.1167/iovs.19-27574] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose The goal was to visualize topographic thickness maps of the intraretinal layers and evaluate their discrimination abilities and relationships with clinical manifestations in patients with multiple sclerosis (MS) and a history of optic neuritis (ON). Methods Thirty patients with relapsing-remitting MS (34 eyes with a history of ON [MSON] and 26 non-ON fellow eyes [MSFE]) were recruited together with 63 age- and sex-matched controls (HC). Ultrahigh resolution optical coherence tomography was used to image the macula and the volumetric data set was segmented to yield six intraretinal layers. Topographic thickness maps were aligned and averaged for the visualization. The thickness maps were partitioned using the Early Treatment Diabetic Retinopathy Study (ETDRS) and related to Sloan low-contrast letter acuity (LCLA), Expanded Disability Status Scale (EDSS), and disease duration. Results Focal thickness reduction occurred in the macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GCIPL), with the most profound reduction occurring in MSON eyes (P < 0.05). A horseshoe-like thickness reduction pattern (U Zone) in the GCIPL appeared in MSON. The thickness of the U Zone had better discrimination power than the ETDRS partitions (area under the curve = 0.97) and differentiated 96% of MSON from HC. The thickness of the U Zone was positively correlated to 2.5% LCLA (r = 0.38, P < 0.05) and 1.25% LCLA (r = 0.57, P < 0.05). Conclusions The horseshoe-like thickness reduction of the GCIPL appeared to be an ON-specific focal thickness alteration with the highest discrimination power of prior ON.
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Affiliation(s)
- Huiling Hu
- 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, Florida, United States
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Giovana Rosa Gameiro
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jeffrey Hernandez
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Silvia Delgado
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
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11
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Shi C, Jiang H, Gameiro GR, Hu H, Hernandez J, Delgado S, Wang J. Visual Function and Disability Are Associated With Focal Thickness Reduction of the Ganglion Cell-Inner Plexiform Layer in Patients With Multiple Sclerosis. Invest Ophthalmol Vis Sci 2019; 60:1213-1223. [PMID: 30913293 PMCID: PMC6892386 DOI: 10.1167/iovs.18-25809] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose The purpose of this study was to visualize the topographic thickness patterns of the intraretinal layers and their associations with clinical manifestations in patients with multiple sclerosis (MS). Methods Ninety-four eyes of 47 relapsing-remitting MS patients without history of optic neuritis were imaged using optical coherence tomography and compared with 134 eyes of 67 healthy subjects. Volumetric data centered on the fovea were segmented to obtain the thickness maps of six intraretinal layers. The thickness measurements partitioned using the Early Treatment Diabetic Retinopathy Study (ETDRS) partition were correlated to the Expanded Disability State Scale (EDSS) and Sloan low contrast visual acuity (LCVA). The receiver-operating characteristics (ROC) curves were calculated to obtain the area under the ROC curves (AUCs). Results The ganglion cell-inner plexiform layer (GCIPL) showed horseshoe-like thickness reduction profoundly at the nasal sector. The most profound thickness reduction zone (circular area, diameter = 1 mm) was located at 2 mm in the nasal sector and 0.4 mm inferior from the fovea, named the “M zone.” The thickness reduction of the M zone was −7.3 μm in MS eyes, which was the most profound alteration, compared to any ETDRS sectors. The AUC of the M zone was 0.75. The relationship between the thickness of the M zone and EDSS (r = −0.59, P < 0.001) or 2.5% LCVA (r = 0.51, P < 0.001) were ranked as the strongest relation compared to any ETDRS sectors. Conclusions This is the first study, to our knowledge, to visualize focal thickness alteration of GCIPL and reveal its relationship to visual function and disability in patients with MS without history of optic neuritis.
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Affiliation(s)
- Ce Shi
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Giovana Rosa Gameiro
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Huiling Hu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Jeffrey Hernandez
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Silvia Delgado
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
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12
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Shao Y, Jiang H, Wei Y, Shi Y, Shi C, Wright CB, Sun X, Vanner EA, Rodriguez AD, Lam BL, Rundek T, Baumel BS, Gameiro GR, Dong C, Wang J. Visualization of Focal Thinning of the Ganglion Cell-Inner Plexiform Layer in Patients with Mild Cognitive Impairment and Alzheimer's Disease. J Alzheimers Dis 2019; 64:1261-1273. [PMID: 30040712 DOI: 10.3233/jad-180070] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND A detailed analysis of the tomographic thickness of intraretinal layers may provide more information on neurodegeneration in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). OBJECTIVE The goal was to analyze tomographic thickness patterns of intraretinal layers in patients with AD andMCI. METHOD Forty-nine patients (25 AD and 24 MCI) and 21 cognitively normal (CN) controls were imaged using ultra-high-resolution optical coherence tomography to obtain volumetric data centered on the fovea. The segmented intraretinal layers were retinal nerve fiber layer (RNFL), ganglion cell- inner plexiform layer (GCIPL), inner nuclear layer (INL), outer nuclear layer (ONL), outer plexiform layer (OPL), and retinal photoreceptor (PR), in addition to the total retinal thickness(TRT). RESULTS The thickness differences were negative (thinning) mainly in TRT, RNFL, and GCIPL in both AD and MCI groups in comparison to CN, while the thickness differences were positive (thickening) mainly in ONL and PR in AD. GCIPL of AD and MCI was thinner in superior, nasal superior, and temporal superior quadrants, compared to CN (p < 0.05). GCIPL of the inner superior, inner nasal superior, inner temporal superior, and outer nasal superior sectors was significantly thinner in AD than CN (p < 0.05). GCIPL of the outer superior, inner temporal superior, outer nasal, and temporal superior sectors was significantly thinner in MCI than CN (p < 0.05). CONCLUSION Focal thinning of the GCIPL was visualized and quantified by detailed partitions in AD and MCI, which provides specific information about neurodegeneration in MCI and AD.
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Affiliation(s)
- Yi Shao
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,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 and the Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yantao Wei
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingying Shi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ce Shi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Xiaoyan Sun
- Department of Neurology and the Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Elizabeth A Vanner
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,BioStatistics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anny D Rodriguez
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.,BioStatistics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Byron L Lam
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tatjana Rundek
- Department of Neurology and the Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Barry S Baumel
- Department of Neurology and the Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovana Rosa Gameiro
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Chuanhui Dong
- Department of Neurology and the Evelyn F. McKnight Brain Institute, 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
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13
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Lin Y, Jiang H, Liu Y, Rosa Gameiro G, Gregori G, Dong C, Rundek T, Wang J. Age-Related Alterations in Retinal Tissue Perfusion and Volumetric Vessel Density. Invest Ophthalmol Vis Sci 2019; 60:685-693. [PMID: 30786280 PMCID: PMC6383727 DOI: 10.1167/iovs.18-25864] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose To determine age-related alterations in the retinal tissue perfusion (RTP) and volumetric vessel density (VVD) in healthy subjects. Methods Total 148 healthy subjects (age 18 to 83 years) were enrolled and divided into four groups (G1, <35 years; G2, 35 ∼ 49 years; G3, 50 ∼ 64 years; and G4, ≥65 years). The RTP and VVD were measured at the macula. The RTP was calculated as the blood flow supplying the macular area (ϕ 2.5 mm) divided by the perfused tissue volume of the inner retina from the inner limiting membrane to the outer plexiform layer. The VVD of the macula (ϕ 2.5 mm) was calculated as the vessel density divided by the corresponding tissue volume. Results The RTP and VVD of the retinal vascular network and deep vascular plexus (DVP) reached a peak in G2. Compared to G2, G4 had significantly lower RTP and VVD of DVP (P < 0.05). After 35 years old, age was negatively related to the RTP (r = −0.26, P = 0.02) and VVD of the DVP (r = −0.47, P < 0.001). However, age was positively related to VVD of the superficial vascular plexus (SVP; r = 0.24, P = 0.04) in subjects aged more than 35 years. The RTP was correlated to VVD measurements (r = 0.23–0.37, P < 0.01). Conclusions This is the first study to reveal the age-related alterations in the RTP and VVD during normal aging in a healthy population. Decreased RTP and VVD in the DVP along with increased VVD in the SVP may represent a characteristic pattern of normal aging in the healthy population.
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Affiliation(s)
- Ying Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.,Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Yi Liu
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.,Department of Ophthalmology, Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Giovana Rosa Gameiro
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Giovanni Gregori
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Chuanhui Dong
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
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14
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A computational framework to investigate retinal haemodynamics and tissue stress. Biomech Model Mechanobiol 2019; 18:1745-1757. [PMID: 31140054 DOI: 10.1007/s10237-019-01172-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
Abstract
The process of vision begins in the retina, yet the role of biomechanical forces in the retina is relatively unknown and only recently being explored. This contribution describes a computational framework involving 3D fluid-structure interaction simulations derived from fundus images that work towards creating unique data on retinal biomechanics. We developed methods to convert 2D fundus photographs into 3D geometries that follow the curvature of the retina. Retina arterioles are embedded into a six-layer representation of the retinal tissue with varying material properties throughout the retinal tissue. Using three different human retinas (healthy, glaucoma, diabetic retinopathy) and by varying our simulation approaches, we report the effects of transient versus steady flow, viscosity assumptions (Newtonian, non-Newtonian and Fåhræus-Lindqvist effect) and rigid versus compliant retinal tissue, on resulting wall shear stress (WSS) and von Mises stress. In the retinal arterioles, the choice of viscosity model is important and WSS obtained from models with the Fåhræus-Lindqvist effect is markedly different from Newtonian and non-Newtonian models. We found little difference in WSS between steady-state and pulsatile simulations (< 5%) and show that WSS varies by about 7% between rigid and deformable models. Comparing the three geometries, we found notably different WSS in the healthy (3.3 ± 1.3 Pa), glaucoma (5.7 ± 1.6 Pa) and diabetic retinopathy cases (4.3 ± 1.1 Pa). Conversely, von Mises stress was similar in each case. We have reported a novel biomechanical framework to explore the stresses in the retina. Despite current limitations and lack of complete subject-specific physiological inputs, we believe our framework is the first of its kind and with further improvements could be useful to better understand the biomechanics of the retina.
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15
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Liu Y, Delgado S, Jiang H, Lin Y, Hernandez J, Deng Y, Gameiro GR, Wang J. Retinal Tissue Perfusion in Patients with Multiple Sclerosis. Curr Eye Res 2019; 44:1091-1097. [PMID: 31046490 DOI: 10.1080/02713683.2019.1612444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose: The goal of this work was to determine whether the retinal tissue perfusion (RTP) is impaired in patients with multiple sclerosis (MS). Methods: Seventy-four patients [66 relapsing-remitting MS (RRMS) and 8 clinically isolated syndrome (CIS)] and 74 age- and gender-matched healthy controls were recruited. RTP was calculated as the retinal blood flow (measured using retinal function imager) supplying the macular area divided by the corresponding tissue volume of the inner retina from the inner limiting membrane to the outer plexiform layer, as measured by ultrahigh-resolution optical coherence tomography. Results: The RTP in the MS group was 2.37 ± 0.59 nl/s/mm3 (mean ± standard deviation), which was significantly lower than the control group (4.06 ± 0.89 nl/s/mm3, P < .001), reflecting a decrease of 42%. The blood flow volume was 2.50 ± 0.50 nl/s in MS, which was 45% lower than in the control group (4.56 ± 0.91 nl/s, P < .001). In addition, the tissue volume of the inner retina was significantly lower than in the control group (P < .05). The RTP in patients with MS was significantly correlated with the retinal blood flow volume (r = 0.84, P < .001) and retinal tissue volume (r = -0.56, P < .001). However, the retinal blood flow in patients with MS was not related to the tissue volume (r = -0.06, P = .59). Conclusions: Impaired retinal tissue perfusion occurred in patients with MS, which could be developed as a possible biomarker in monitoring disease progression in MS.
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Affiliation(s)
- Yi Liu
- Department of Ophthalmology, Third Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing , China.,Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Silvia Delgado
- MS Center of Excellence, Department of Neurology, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.,MS Center of Excellence, Department of Neurology, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Ying Lin
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , Guangdong , China
| | - Jeffrey Hernandez
- MS Center of Excellence, Department of Neurology, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Yuqing Deng
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University , Guangzhou , Guangdong , China
| | - Giovana Rosa Gameiro
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA
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16
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Lamin A, Oakley JD, Dubis AM, Russakoff DB, Sivaprasad S. Changes in volume of various retinal layers over time in early and intermediate age-related macular degeneration. Eye (Lond) 2018; 33:428-434. [PMID: 30310161 DOI: 10.1038/s41433-018-0234-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To evaluate longitudinally volume changes in inner and outer retinal layers in early and intermediate age-related macular degeneration (AMD) compared to healthy control eyes using optical coherence tomography (OCT). METHODS 71 eyes with AMD and 31 control eyes were imaged at two time points: baseline and after 2 years. Automated OCT layer segmentation was performed using OrionTM. This software is able to measure volumes of retinal layers with distinct boundaries including Retinal Nerve Fibre Layer (RNFL), Ganglion Cell-Inner Plexiform Layer (GCIPL), Inner Nuclear Layer (INL), Outer Plexiform Layer (OPL), Outer Nuclear Layer (ONL), Photoreceptors (PR) and Retinal Pigment Epithelium-Bruch's Membrane complex (RPE-BM). The mean retinal layer volumes and volume changes at 2 years were compared between groups. RESULTS Mean GCIPL and INL volumes were lower, while PR and RPE-BM volumes were higher in AMD eyes than controls at baseline (all P < 0.05) and year 2 (all P < 0.05). In AMD eyes, RNFL and ONL volumes decreased by 0.0232 (P = 0.033) and 0.0851 (P = 0.001), respectively. In contrast, OPL and RPE-BM volumes increased in AMD eyes by 0.0391 (P = 0.000) and 0.0209 (P = 0.000) respectively. Moreover, there were significant differences in longitudinal volume change of OPL (P = 0.02), ONL (P = 0.008) and RPE-BM (P = 0.02) between AMD eyes and controls. CONCLUSIONS There were abnormal retinal layer volumes and volume changes in eyes with early and intermediate AMD.
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Affiliation(s)
- Ali Lamin
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,UCL Institute of Ophthalmology, London, UK
| | | | - Adam M Dubis
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,UCL Institute of Ophthalmology, London, UK
| | | | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK. .,UCL Institute of Ophthalmology, London, UK.
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17
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Qu D, Lin Y, Jiang H, Shao Y, Shi Y, Airen S, Gregori G, Wang J. Retinal nerve fiber layer (RNFL) integrity and its relations to retinal microvasculature and microcirculation in myopic eyes. EYE AND VISION 2018; 5:25. [PMID: 30349842 PMCID: PMC6190551 DOI: 10.1186/s40662-018-0120-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/26/2018] [Indexed: 11/10/2022]
Abstract
Background The aim was to determine retinal nerve fiber layer function and its relations to retinal microvasculature and microcirculation in patients with myopia. Method Polarization-sensitive optical coherence tomography (PS-OCT) was used to measure phase retardation per unit depth (PR/UD, proportional to the birefringence) of the retinal nerve fiber layer (RNFL). Optical coherence tomography angiography (OCTA) was used to measure macular vessel density analyzed using fractal analysis. In addition, a retinal function imager (RFI) was used to measure macular blood flow velocities in arterioles and venules. Twenty-two patients with moderate myopia (MM, refraction > 3 and < 6 diopters), seventeen patients with high myopia (HM, ≥ 6 D) and 29 healthy control subjects (HC, ≤ 3.00 D) were recruited. One eye of each patient was imaged. Results Although the average PR/UD of the RNFL in the HM group did not reach a significant level, the birefringence of the inferior quadrant was significantly lower (P < 0.05) in the HM group compared to the HC group. Significant thinning of the average RNFL and focal thinning of RFNL in temporal, superior and inferior quadrants in the HM group were found, compared to the HC group (P < 0.05). There were no significant differences of retinal blood flow velocities in arterioles and venules among groups (P > 0.05). The macular vessel density in both superficial and deep vascular plexuses was significantly lower in the HM group than in the other two groups (P < 0.05) as well as in the MM group than in the HC group (P < 0.05). The average PR/UD and PR/UD in the inferior quadrant were not related to refraction, axial length, blood flow velocities and macular vessel densities (r ranged from − 0.09 to 0.19, P > 0.05). Conclusions The impairment of the retinal nerve fiber birefringence in the HM group may be one of the independent features in high myopic eyes, which appeared not to relate to macular microvascular density and blood flow velocity.
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Affiliation(s)
- Dongyi Qu
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Ying Lin
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA.,2State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Hong Jiang
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA.,3Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Yi Shao
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Yingying Shi
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Shriya Airen
- 4College of Arts and Sciences, University of Miami, Miami, FL USA
| | - Giovanni Gregori
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA
| | - Jianhua Wang
- 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL USA.,5Department of Ophthalmology Bascom Palmer Eye Institute, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
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18
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Gameiro GR, Jiang H, Liu Y, Deng Y, Sun X, Nascentes B, Baumel B, Rundek T, Wang J. Retinal tissue hypoperfusion in patients with clinical Alzheimer's disease. EYE AND VISION 2018; 5:21. [PMID: 30140712 PMCID: PMC6097197 DOI: 10.1186/s40662-018-0115-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/02/2018] [Indexed: 12/19/2022]
Abstract
Background It remains unknow whether retinal tissue perfusion occurs in patients with Alzheimer’s disease. The goal was to determine retinal tissue perfusion in patients with clinical Alzheimer’s disease (CAD). Methods Twenty-four CAD patients and 19 cognitively normal (CN) age-matched controls were recruited. A retinal function imager (RFI, Optical Imaging Ltd., Rehovot, Israel) was used to measure the retinal blood flow supplying the macular area of a diameter of 2.5 mm centered on the fovea. Blood flow volumes of arterioles (entering the macular region) and venules (exiting the macular region) of the supplied area were calculated. Macular blood flow was calculated as the average of arteriolar and venular flow volumes. Custom ultra-high-resolution optical coherence tomography (UHR–OCT) was used to calculate macular tissue volume. Automated segmentation software (Orion, Voxeleron LLC, Pleasanton, CA) was used to segment six intra-retinal layers in the 2.5 mm (diameter) area centered on the fovea. The inner retina (containing vessel network), including retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer (INL) and outer plexiform layer (OPL), was segmented and tissue volume was calculated. Perfusion was calculated as the flow divided by the tissue volume. Results The tissue perfusion in CAD patients was 2.58 ± 0.79 nl/s/mm3 (mean ± standard deviation) and was significantly lower than in CN subjects (3.62 ± 0.44 nl/s/mm3, P < 0.01), reflecting a decrease of 29%. The flow volume was 2.82 ± 0.92 nl/s in CAD patients, which was 31% lower than in CN subjects (4.09 ± 0.46 nl/s, P < 0.01). GCIPL tissue volume was 0.47 ± 0.04 mm3 in CAD patients and 6% lower than CN subjects (0.50 ± 0.05 mm3, P < 0.05). No other significant alterations were found in the intra-retinal layers between CAD and CN participants. Conclusions This study is the first to show decreased retinal tissue perfusion that may be indicative of diminished tissue metabolic activity in patients with clinical Alzheimer’s disease.
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Affiliation(s)
- Giovana Rosa Gameiro
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
| | - Hong Jiang
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA.,2Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Yi Liu
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA.,3Department of Ophthalmology, Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuqing Deng
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA.,4State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Xiaoyan Sun
- 2Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Bernardo Nascentes
- 5School of Nursing and Health Studies, University of Miami, Miami, FL USA
| | - Bernard Baumel
- 2Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Tatjana Rundek
- 2Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL USA
| | - Jianhua Wang
- 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL 33136 USA
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19
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Retinal layers thickness changes following epiretinal membrane surgery. Eye (Lond) 2017; 32:555-562. [PMID: 29125147 DOI: 10.1038/eye.2017.233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/15/2017] [Indexed: 01/22/2023] Open
Abstract
PurposeTo evaluate the time course of changes in the thickness of retinal layers after epiretinal membrane (ERM) removal surgery.MethodsA retrospective cohort study of patients following surgery for idiopathic ERM. We used new specialized image analysis software to create a thickness map of each retinal layer and analyzed changes during one year follow-up. Healthy fellow eyes were used as negative controls and the retina prior to surgery as positive control.ResultsTwenty-one patients were included with a mean age of 68±13 years. Central macular thickness decreased steadily until 6 months after surgery (25% decrease, 516±76 to 386±73 μm, P<0.001) with no further decrease between 6 and 12 months (386±73 to 390±73 μm, P=0.291). The retinal nerve fiber layer (RNFL), and the ganglion cell and inner plexiform layer (GCIPL) were most affected (57%, P<0.001 and 27%, P=0.010, respectively). The thickest region showed a more abrupt decrease of 21% at first follow-up (504±61 to 399±58 μm, P=0.001) with subsequent decrements of about 3%. Prior to surgery all retinal layers were thicker in study eyes compared with healthy control eyes (6-63%, all P<0.05).ConclusionsFollowing ERM surgery, in the course of 6 months, the macula gradually becomes thinner after which a stable state is reached. All layers appear to be affected, with the RNFL and GCIPL impacted the most. Our results provide a unique view on how the thickness of different retinal layers changes following ERM surgery.
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20
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Wei Y, Jiang H, Shi Y, Qu D, Gregori G, Zheng F, Rundek T, Wang J. Age-Related Alterations in the Retinal Microvasculature, Microcirculation, and Microstructure. Invest Ophthalmol Vis Sci 2017; 58:3804-3817. [PMID: 28744554 PMCID: PMC5527847 DOI: 10.1167/iovs.17-21460] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose To characterize age-related alterations in the retinal microcirculation, microvascular network, and microstructure in healthy subjects. Methods Seventy-four healthy subjects aged from 18 to 82 years were recruited and divided into four age groups (G1 with age <35 years, G2 with age 35 ∼ 49 years, G3 with age 50 ∼ 64 years, and G4 with age ≥65 years). Custom ultra-high resolution optical coherence tomography (UHR-OCT) was used to acquire six intraretinal layers of the macula. OCT angiography (OCTA) was used to image the retinal microvascular network. The retinal blood flow velocity (BFV) was measured using a Retinal Function Imager (RFI). Results Compared to G1, G2 had significant thinning of the retinal nerve fiber layer (RNFL) (P < 0.05), while G3 had thinning of the RNFL and ganglion cell and inner plexiform layer (GCIPL) (P < 0.05), in addition to thickening of the outer plexiform layer (OPL) and photoreceptor layer (PR) (P < 0.05). G4 had loss in retinal vessel density, thinning in RNFL and GCIPL, and decrease in venular BFV, in addition to thickening of the OPL and PR (P < 0.05). Age was negatively related to retinal vessel densities, the inner retinal layers, and venular BFV (P < 0.05). By contrast, age was positively related to OPL and PR (P < 0.05). Conclusions During aging, decreases in retinal vessel density, inner retinal layer thickness, and venular BFV were evident and impacted each other as observed by simultaneous changes in multiple retinal components.
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Affiliation(s)
- Yantao Wei
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China,Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Yingying Shi
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Dongyi Qu
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Giovanni Gregori
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Fang Zheng
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
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