1
|
Huang KI, Su FY, Ho HY, Ho HC, Chen YW, Lee CK, Lai F, Lu HHS, Ko ML. Axial length, more than aging, decreases the thickness and superficial vessel density of retinal nerve fiber layer in non-glaucomatous eyes. Int Ophthalmol 2024; 44:130. [PMID: 38478099 PMCID: PMC10937793 DOI: 10.1007/s10792-024-02961-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/04/2023] [Indexed: 03/17/2024]
Abstract
PURPOSE This study seeks to build a normative database for the vessel density of the superficial retina (SVD) and evaluate how changes and trends in the retinal microvasculature may be influenced by age and axial length (AL) in non-glaucomatous eyes, as measured with optical coherence tomography angiography (OCTA). METHODS We included 500 eyes of 290 healthy subjects visiting a county hospital. Each participant underwent comprehensive ophthalmological examinations and OCTA to measure the SVD and thickness of the macular and peripapillary areas. To analyze correlations between SVD and age or AL, multivariable linear regression models with generalized estimating equations were applied. RESULTS Age was negatively correlated with the SVD of the superior, central, and inferior macular areas and the superior peripapillary area, with a decrease rate of 1.06%, 1.36%, 0.84%, and 0.66% per decade, respectively. However, inferior peripapillary SVD showed no significant correlation with age. AL was negatively correlated with the SVD of the inferior macular area and the superior and inferior peripapillary areas, with coefficients of -0.522%/mm, -0.733%/mm, and -0.664%/mm, respectively. AL was also negatively correlated with the thickness of the retinal nerve fiber layer and inferior ganglion cell complex (p = 0.004). CONCLUSION Age and AL were the two main factors affecting changes in SVD. Furthermore, AL, a relative term to represent the degree of myopia, had a greater effect than age and showed a more significant effect on thickness than on SVD. This relationship has important implications because myopia is a significant issue in modern cities.
Collapse
Affiliation(s)
- Kuan-I Huang
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Fang-Ying Su
- Institute of Statistics, National Chiao Tung University, Hsinchu City, Taiwan
- Biotechnology R&D Center, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Heng-Yen Ho
- School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Heng-Chen Ho
- School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yan-Wu Chen
- Department of Applied Mathematics, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Chih-Kuo Lee
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | | | - Mei-Lan Ko
- Department of Ophthalmology, National Taiwan University Hospital, Hsin Chu Branch, Hsinchu City, Taiwan.
- Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu City, Taiwan.
| |
Collapse
|
2
|
Yan C, Zhao F, Gao S, Liu X, Yu T, Mu Y, Zhang L, Xu J. Observation of the effect of posterior scleral reinforcement combined with orthokeratology and 0.01% atropine in the treatment of congenital myopia: a case report. BMC Ophthalmol 2023; 23:486. [PMID: 38012561 PMCID: PMC10683125 DOI: 10.1186/s12886-023-03211-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Myopia has recently emerged as a significant threat to global public health. The high and pathological myopia in children and adolescents could result in irreversible damage to eye tissues and severe impairment of visual function without timely control. Posterior scleral reinforcement (PSR) can effectively control the progression of high myopia by limiting posterior scleral expansion, improving retrobulbar vascular perfusion, thereby stabilizing the axial length and refraction of the eye. Moreover, orthokeratology and low concentrations of atropine are also effective in slowing myopia progression. CASE PRESENTATION A female child was diagnosed with binocular congenital myopia and amblyopia at the age of 3 and the patient's vision had never been rectified with spectacles at the first consultation. The patient's ophthalmological findings suggested, high refractive error with low best corrected visual acuity, longer axial length beyond the standard level of her age, and fundus examination suggesting posterior scleral staphyloma with weakened hemodynamics of the posterior ciliary artery. Thereby, PSR was performed to improve fundus health and the combination of orthokeratology and 0.01% atropine were performed to control the development of myopia. Following up to 8 years of clinical treatment and observations, the progression of myopia could be well controlled and fundus health was stable. CONCLUSION In this report, 8-year of clinical observation indicated that PSR could improve choroidal thickness and hemodynamic parameters of the retrobulbar vessels, postoperative orthokeratology combined with 0.01% atropine treatment strategy may be a good choice for myopia control effectively.
Collapse
Affiliation(s)
- Chunxiao Yan
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Fangkun Zhao
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shang Gao
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoyu Liu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
| | - Taorui Yu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Yanan Mu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
| | - Lijun Zhang
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China.
- Dalian Medical University, Dalian, Liaoning, China.
| | - Jun Xu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China.
| |
Collapse
|
3
|
Zhang Z, Mu J, Wei J, Geng H, Liu C, Yi W, Sun Y, Duan J. Correlation between refractive errors and ocular biometric parameters in children and adolescents: a systematic review and meta-analysis. BMC Ophthalmol 2023; 23:472. [PMID: 37990308 PMCID: PMC10662558 DOI: 10.1186/s12886-023-03222-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Refractive errors are one of the most common ocular conditions among children and adolescents, with myopia showing an increasing prevalence and early onset in this population. Recent studies have identified a correlation between refractive errors and ocular biometric parameters. METHODS A systematic search was conducted in electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, and Medline from January 1, 2012, to May 1, 2023. Various ocular biometric parameters were summarized under different refractive states, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), corneal curvature (CC), Corneal curvature radius (CR),axial length-to-corneal radius ratio (AL/CR ratio), choroidal thickness (ChT), retinal thickness (RT), retinal nerve fiber layer thickness (RNFL), and retinal blood density (VD). The differences in these parameters among different refractive states were analyzed using Stata software with fixed or random-effects models, taking into account the assessed heterogeneity level. RESULTS This meta-analysis included a total of 69 studies involving 128,178 eyes, including 48,795 emmetropic eyes, 60,691 myopic eyes, 13,983 hyperopic eyes, 2,040 low myopic eyes, 1,201 moderate myopic eyes, and 1,468 high myopic eyes. The results of our study demonstrated that, compared to the control group (emmetropic group), the myopic group and low, moderate, and high myopic groups showed significant increases in AL, AL/CR ratio, and ACD, while the hyperopic group exhibited significant decreases. Compared to the control group, the myopic group had a significantly increase for CC, while CR, CCT, perifoveal RT, subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal (except nasal) ChT, and pRNFL (except temporal) significantly decreased. Compared to the control group, the hyperopic group had a significantly increase for subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal ChT, and nasal pRNFL. Compared to the control group, the low and moderate myopic groups had a significantly decreases for the CCT, parafoveal RT (except nasal), perifoveal RT (except nasal), and pRNFL (except superior and temporal). Compared to the control group, the high myopic group had a significantly increase for CR, while LT, perifoveal ChT (except nasal), parafoveal RT, perifoveal RT, and pRNFL (except temporal) had significant decreased. CONCLUSION The changes of ocular biometric parameters in children and adolescents are closely related to refractive errors. Ocular biometric parameters devices, as effective non-invasive techniques, provide objective biological markers for monitoring refractive errors such as myopia.
Collapse
Affiliation(s)
- Zengrui Zhang
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jingyu Mu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jing Wei
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Haoming Geng
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Chunmeng Liu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Wenhua Yi
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Yue Sun
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Junguo Duan
- Chengdu University of TCM, Chengdu, Sichuan, China.
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China.
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection with TCM Laboratory, Chengdu, Sichuan, China.
| |
Collapse
|
4
|
Benavente-Perez A. Evidence of vascular involvement in myopia: a review. Front Med (Lausanne) 2023; 10:1112996. [PMID: 37275358 PMCID: PMC10232763 DOI: 10.3389/fmed.2023.1112996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
The benign public perception of myopia (nearsightedness) as a visual inconvenience masks the severity of its sight-threatening consequences. Myopia is a significant risk factor for posterior pole conditions such as maculopathy, choroidal neovascularization and glaucoma, all of which have a vascular component. These associations strongly suggest that myopic eyes might experience vascular alterations prior to the development of complications. Myopic eyes are out of focus because they are larger in size, which in turn affects their overall structure and function, including those of the vascular beds. By reviewing the vascular changes that characterize myopia, this review aims to provide an understanding of the gross, cellular and molecular alterations identified at the structural and functional levels with the goal to provide an understanding of the latest evidence in the field of experimental and clinical myopia vascular research. From the evidence presented, we hypothesize that the interaction between excessive myopic eye growth and vascular alterations are tipping-points for the development of sight-threatening changes.
Collapse
|
5
|
Małyszczak A, Żyto M, Przeździecka-Dołyk J, Misiuk-Hojło M. Macular Vascularity and Ganglion Cell Complex Parameters in the Young Adults with Myopia and Progressive Myopia. Clin Ophthalmol 2023; 17:561-570. [PMID: 36817636 PMCID: PMC9930574 DOI: 10.2147/opth.s389963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/06/2022] [Indexed: 02/13/2023] Open
Abstract
Purpose The purpose of this study is to determine the relationships between foveal avascular zone (FAZ), foveal vascular density (FD) and GCC (ganglion cell complex) parameters in a healthy myopic population using optical coherence tomography angiography (angio-OCT). Patients and Methods Three hundred and eighty-one eyes of 381 healthy participants were included into this study and assigned to three groups according to their spherical equivalent (SE) values and an additional progressive myopia group. One randomly chosen eye from each patient was analyzed. GCC mean thickness, focal loss of volume (FLV), global loss of volume (GLV), FAZ area, FAZ perimeter, and FD parameters were obtained with the RTVue AngioOCT device. Results FAZ area and its perimeter were strongly correlated with the belonging spherical equivalent group (p = 0.0001, p = 0.0008 accordingly), being the largest in progressive myopia subgroup (mean size 0.42mm2). Other factors that were significantly higher in myopic eyes were FLV (p = 0.0023), GLV (p = 0.0020). There were no differences in FD between groups. In the myopic and progressive myopia groups, there was a significant relationship between FAZ area and FLV, GLV, and GCC thickness. We found that in myopic eyes with AXL exceeding 26.6 mm, FAZ becomes negatively correlated to mean GCC thickness. Conclusion In myopia, compared to non-myopic groups, there is a greater loss of neural tissue represented by a thinner GCC layer, greater FLV and GLV parameters, and worse blood supply represented by a larger FAZ area. Eye axial length of 26.6 mm is a breaking point, where the negative FAZ area to GCC thickness relationship curve is getting significantly steeper.
Collapse
Affiliation(s)
- Artur Małyszczak
- Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland,Correspondence: Artur Małyszczak, Department and Clinic of Ophthalmology, Wroclaw Medical University, Borowska 213 50-556, Wroclaw, Dolnoslaskie, Poland, Email
| | - Magdalena Żyto
- Department of Optics and Photonics, Wroclaw University of Science and Technology, Wroclaw, Dolnoslaskie, Poland
| | - Joanna Przeździecka-Dołyk
- Department of Optics and Photonics, Wroclaw University of Science and Technology, Wroclaw, Dolnoslaskie, Poland
| | - Marta Misiuk-Hojło
- Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland
| |
Collapse
|
6
|
Wang XQ, Chen M, Zeng LZ, Liu LQ. Investigation of retinal microvasculature and choriocapillaris in adolescent myopic patients with astigmatism undergoing orthokeratology. BMC Ophthalmol 2022; 22:382. [PMID: 36151522 PMCID: PMC9508713 DOI: 10.1186/s12886-022-02572-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Background To observe alterations of fundus microcirculation and retinal thickness in adolescent myopic patients with astigmatism after toric and spherical orthokeratology using optical coherence tomography angiography (OCTA), to explore the effects of orthokeratology on the retinal thickness and choroidal blood flow. Methods A total of 48 patients were enrolled and divided into two group (toric orthokeratology (T) group and spherical orthokeratology (S) group) according to the type of lens design. OCTA was used to measure the superficial and deep retinal vessel densities at the macular region, radial peripapillary capillary (RPC) density, foveal avascular zone (FAZ) area, and choriocapillaris (ChC) perfusion area before and after orthokeratology for 3 months. The data were statistically analyzed by SPSS 19.0 software. Results Compared with before orthokeratology, the superficial vessel density in the fovea and parafovea in the T group significantly increased, and the deep vessel density in the whole area and fovea were significantly elevated after 3 months (P < 0.05). The superficial vessel density was significantly higher only in the parafovea in the S group after 3 months than that before orthokeratology (P < 0.05), deep vessel density in the whole area and parafovea after 3 months was significantly higher than that before orthokeratology (P < 0.05). RPC density in the two groups increased after 3 months of orthokeratology in the whole area and inside the disc area (P < 0.05). Three months after toric orthokeratology, FAZ area in the T group was significantly reduced by 0.05 (− 0.41 to + 0.08) mm2, while ChC perfusion area was enlarged by 0.06 ± 0.12 mm2. FAZ area in the S group significantly decreased by 0.01 (− 0.19 to + 0.01) mm2, whereas ChC perfusion area increased by 0.06 (− 0.07 to + 0.50) mm2. Retinal thickness in the two groups increased after 3 months of orthokeratology in the whole area and parafoveal area (P < 0.05). Conclusion Orthokeratology improved retinal blood flow in macular area and RPC while controlling myopia. The changes in FAZ and ChC perfusion areas did not significantly differ between toric and spherical orthokeratology.
Collapse
Affiliation(s)
- Xiao-Qin Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, Sichuan Province, 610041, China.,The Department of Ophthalmology, Chengdu First People's Hospital/Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan Province, 610041, China
| | - Ming Chen
- The Department of Ophthalmology, Chengdu First People's Hospital/Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan Province, 610041, China
| | - Liu-Zhi Zeng
- The Department of Ophthalmology, Chengdu First People's Hospital/Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan Province, 610041, China
| | - Long-Qian Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, Sichuan Province, 610041, China.
| |
Collapse
|
7
|
Dong YM, Zhu HY, Liu ZH, Fu SY, Wang K, Du LP, Jin XM. Various configuration types of the foveal avascular zone with related factors in normal Chinese adults with or without myopia assessed by swept-source OCT angiography. Int J Ophthalmol 2022; 15:1502-1510. [PMID: 36124188 DOI: 10.18240/ijo.2022.09.14] [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: 04/25/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To describe the morphological characteristics of foveal avascular zone (FAZ) in normal Chinese adults with or without myopia by swept-source optical coherence tomography angiography (SS-OCTA) and analyze the possible associated factors. METHODS Normal Chinese adults with or without myopia aged between 18 and 60y were recruited into the study. One eye in each individual was randomly selected for scanning using SS-OCTA. FAZ parameters, central retinal thickness (CRT) and central choroidal thickness (CCT) were then analyzed. Correlations between systemic and ocular variables and FAZ parameters were subsequently evaluated. The subgroup analysis based on refractive error was also carried out. RESULTS In total, 127 eyes out of 127 normal subjects were finally included in the study (mean age 29.5±8.22y, 61 males and 66 females). The pattern of FAZ was variable: round configuration in 28 eyes (22%), quadrilateral configuration in 23 eyes (18%), pentagonal configuration in 20 eyes (16%), oval configuration in 15 eyes (12%), triangular configuration in 6 eyes (5%) and irregular configuration in 35 eyes (28%). The mean area of FAZ was 0.37±0.12 mm2. Females had a larger FAZ (0.41±0.11 mm2 vs 0.32±0.11 mm2) compared with that of males (P<0.01). All myopic individuals showed smaller FAZ area and perimeter compared with that of normal individuals (P<0.01). There was no obvious correlation between age and FAZ. In the univariate regression analysis, both axial length (AL) and refractive error were significantly related to FAZ parameters. However, only CRT showed negative correlation with FAZ in the multivariate regression analysis. CONCLUSION The pattern of FAZ configuration in normal Chinese adults with or without myopia is highly variable. Establishing quantitative parameters of FAZ would not only provide details of macular pathophysiology but could possibly contribute as a biomarker in disease staging.
Collapse
Affiliation(s)
- Yan-Min Dong
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Hai-Yan Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Zhen-Hui Liu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Shu-Ying Fu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Ke Wang
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Li-Ping Du
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| | - Xue-Min Jin
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
| |
Collapse
|
8
|
Hemodynamic and morphological changes of the central retinal artery in myopic eyes. Sci Rep 2022; 12:7104. [PMID: 35501327 PMCID: PMC9061854 DOI: 10.1038/s41598-022-11087-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
Due to excessive elongation of the eyeball, myopia-related vascular abnormalities are frequently observed in the central retinal artery (CRA) and its intraretinal branches. In addition to inconsistency in previously reported findings, hemodynamic (reduced flow velocity, increased vascular resistance) and morphological changes (narrower vessel diameter) were usually studied separately. This cross-sectional study evaluated the hemodynamic and morphological characteristics concurrently in a large sample of healthy myopes, by using the color Doppler ultrasound and adaptive optics retinal camera. Results showed that the retrobulbar segment of CRA had a tendency of slightly reduced flow velocity in eyeballs with longer axial length, but the correlation was not significant after adjusting for the multiple correlations. Vascular resistance was not affected by the axial elongation. With respect to the intraretinal branches, no significant changes in longer eyes of total diameter or lumen diameter were observed, while both the wall thickness and the wall cross-sectional area were significantly increased, but only a marginally increase in the wall to lumen ratio was found with increasing axial length. This implies some potential small artery remodeling in the intraretinal CRA branches. Overall, blood supply of the inner retina in healthy young myopes is likely to be maintained. Additionally, morphological parameters of vascular microstructure could be potential biomarkers to monitor myopia progression and understand myopia-related vascular abnormalities in future studies.
Collapse
|
9
|
Ji Y, Shi L, Cheng Q, Fu WW, Zhong PP, Huang SQ, Chen XL, Wu XR. Abnormal Large-Scale Neuronal Network in High Myopia. Front Hum Neurosci 2022; 16:870350. [PMID: 35496062 PMCID: PMC9051506 DOI: 10.3389/fnhum.2022.870350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
Aim Resting state functional magnetic resonance imaging (rs-fMRI) was used to analyze changes in functional connectivity (FC) within various brain networks and functional network connectivity (FNC) among various brain regions in patients with high myopia (HM). Methods rs-fMRI was used to scan 82 patients with HM (HM group) and 59 healthy control volunteers (HC group) matched for age, sex, and education level. Fourteen resting state networks (RSNs) were extracted, of which 11 were positive. Then, the FCs and FNCs of RSNs in HM patients were examined by independent component analysis (ICA). Results Compared with the HC group, FC in visual network 1 (VN1), dorsal attention network (DAN), auditory network 2 (AN2), visual network 3 (VN3), and sensorimotor network (SMN) significantly increased in the HM group. FC in default mode network 1 (DMN1) significantly decreased. Furthermore, some brain regions in default mode network 2 (DMN2), default mode network 3 (DMN3), auditory network 1 (AN1), executive control network (ECN), and significance network (SN) increased while others decreased. FNC analysis also showed that the network connection between the default mode network (DMN) and cerebellar network (CER) was enhanced in the HM group. Conclusion Compared with HCs, HM patients showed neural activity dysfunction within and between specific brain networks, particularly in the DMN and CER. Thus, HM patients may have deficits in visual, cognitive, and motor balance functions.
Collapse
|
10
|
Liu X, Wang Y, Ying X, Zhang F, Huang J, Yu H, Wang Q, Zheng M, Hou F, Lesmes L, Lu ZL, Lu F, Mao X. Contrast Sensitivity Is Associated With Chorioretinal Thickness and Vascular Density of Eyes in Simple Early-Stage High Myopia. Front Med (Lausanne) 2022; 9:847817. [PMID: 35402440 PMCID: PMC8988058 DOI: 10.3389/fmed.2022.847817] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/01/2022] [Indexed: 12/18/2022] Open
Abstract
ObjectiveTo evaluate the contrast sensitivity function (CSF), chorioretinal thickness and vascular density as well as their relationships in subjects with simple early-stage high myopia.MethodsEighty-one young subjects were enrolled in this study. They were categorized into the simple high myopia group (sHM, n = 51) and the low-moderate myopia group (control group, n = 30). Monocular CSF under best correction was measured with the qCSF method. Retinal superficial and deep vascular density, inner and outer retinal thickness and choroidal thickness were measured using optical coherence tomography angiography.ResultsThe area under log CSF (AULCSF) and cutoff spatial frequency (Cutoff SF) of the sHM group were significantly reduced compared to those of the control group (P = 0.003 and P < 0.001, respectively). The parafoveal and perifoveal retinal thickness, deep vascular density and choroidal thickness were also significantly reduced in the sHM group (all P < 0.05). Multiple regression analysis revealed that AULCSF was significantly correlated with retinal deep vascular density, outer retinal thickness in the parafoveal and perifoveal areas (all P < 0.05).ConclusionCompared to low to moderate myopic eyes, patients with simple high myopia have thinner retinal and choroidal thickness, lower retinal vascular density, and reduced contrast sensitivity. Moreover, the CSF was correlated with the measures of chorioretinal structure and vasculature. The results suggest that the CSF is a sensitive functional endpoint in simple early-stage high myopia.
Collapse
Affiliation(s)
- Xinting Liu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yanli Wang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | | | - Fen Zhang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jing Huang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hang Yu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qian Wang
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Miaoran Zheng
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fang Hou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Luis Lesmes
- Adaptive Sensory Technology, Inc., San Diego, CA, United States
| | - Zhong-Lin Lu
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China
- Center for Neural Science, Department of Psychology, New York University, New York, NY, United States
- NYU-ECNU Institute of Brain and Cognitive Science, NYU Shanghai, Shanghai, China
- *Correspondence: Zhong-Lin Lu,
| | - Fan Lu
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Fan Lu,
| | - Xinjie Mao
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Xinjie Mao,
| |
Collapse
|
11
|
Zhu Q, Chen C, Yao J. Kearns–Sayre syndrome with a novel large-scale deletion: a case report. BMC Ophthalmol 2022; 22:35. [PMID: 35073857 PMCID: PMC8785533 DOI: 10.1186/s12886-021-02224-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Background Kearns–Sayre syndrome (KSS) is a rare, multisystem mitochondrial encephalomyopathy. We report a case of KSS with a novel 7.6-kb deletion as assessed through a long-range polymerase chain reaction (PCR) study in the blood. In addition, optical coherence tomography angiography (OCTA) confirmed deep retinal capillary atrophy for the first time. Case presentation A 13-year-old patient presented with progressive vision loss and difficulty with eye opening and was diagnosed with progressive external ophthalmoplegia and retinitis pigmentosa (RP). The patient also experienced heart block, vestibular dysfunction, growth retardation and multiple demyelinating lesions. A long-range PCR study in the blood revealed a large-scale Chrm: 6341–13,993 deletion, which was first reported and broadened the genetic spectrum of this disease. The patient underwent complete ophthalmic examination, medical history review and gene detection, resulting in a confirmation of the diagnosis of KSS. The patient was given a pair of applicable glasses to wear and was followed up every 3 months. An implantable pacemaker was also installed based on the advice of the physician. Conclusions We reported a novel large-scale deletion in the mitochondrial DNA of KSS, and OCTA was used for the first time to confirm deep retinal capillary atrophy. Furthermore, because ophthalmic symptoms are often the primary manifestation of KSS, the relationship between ophthalmology and mitochondrial diseases should be emphasised.
Collapse
|
12
|
Mao J, Deng X, Ye Y, Liu H, Fang Y, Zhang Z, Chen N, Sun M, Shen L. Morphological characteristics of retinal vessels in eyes with high myopia: Ultra-wide field images analyzed by artificial intelligence using a transfer learning system. Front Med (Lausanne) 2022; 9:956179. [PMID: 36874950 PMCID: PMC9982751 DOI: 10.3389/fmed.2022.956179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/27/2022] [Indexed: 02/18/2023] Open
Abstract
Purpose The purpose of this study is to investigate the retinal vascular morphological characteristics in high myopia patients of different severity. Methods 317 eyes of high myopia patients and 104 eyes of healthy control subjects were included in this study. The severity of high myopia patients is classified into C0-C4 according to the Meta Analysis of the Pathologic Myopia (META-PM) classification and their vascular morphological characteristics in ultra-wide field imaging were analyzed using transfer learning methods and RU-net. Correlation with axial length (AL), best corrected visual acuity (BCVA) and age was analyzed. In addition, the vascular morphological characteristics of myopic choroidal neovascularization (mCNV) patients and their matched high myopia patients were compared. Results The RU-net and transfer learning system of blood vessel segmentation had an accuracy of 98.24%, a sensitivity of 71.42%, a specificity of 99.37%, a precision of 73.68% and a F1 score of 72.29. Compared with healthy control group, high myopia group had smaller vessel angle (31.12 ± 2.27 vs. 32.33 ± 2.14), smaller fractal dimension (Df) (1.383 ± 0.060 vs. 1.424 ± 0.038), smaller vessel density (2.57 ± 0.96 vs. 3.92 ± 0.93) and fewer vascular branches (201.87 ± 75.92 vs. 271.31 ± 67.37), all P < 0.001. With the increase of myopia maculopathy severity, vessel angle, Df, vessel density and vascular branches significantly decreased (all P < 0.001). There were significant correlations of these characteristics with AL, BCVA and age. Patients with mCNV tended to have larger vessel density (P < 0.001) and more vascular branches (P = 0.045). Conclusion The RU-net and transfer learning technology used in this study has an accuracy of 98.24%, thus has good performance in quantitative analysis of vascular morphological characteristics in Ultra-wide field images. Along with the increase of myopic maculopathy severity and the elongation of eyeball, vessel angle, Df, vessel density and vascular branches decreased. Myopic CNV patients have larger vessel density and more vascular branches.
Collapse
Affiliation(s)
- Jianbo Mao
- Department of Ophthalmology, Center for Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.,Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinyi Deng
- Department of Ophthalmology, Center for Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.,Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Ye
- Department of Precision Machinery and Instrumentation, University of Science and Technology of China, Hefei, China
| | - Hui Liu
- Department of Precision Machinery and Instrumentation, University of Science and Technology of China, Hefei, China
| | - Yuyan Fang
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhengxi Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Nuo Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingzhai Sun
- Department of Precision Machinery and Instrumentation, University of Science and Technology of China, Hefei, China
| | - Lijun Shen
- Department of Ophthalmology, Center for Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.,Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| |
Collapse
|
13
|
Vessel Density and Retinal Thickness from Optical Coherence Tomography Angiography as New Indexes in Adolescent Myopia. J Ophthalmol 2021; 2021:6069833. [PMID: 34956668 PMCID: PMC8694993 DOI: 10.1155/2021/6069833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/28/2021] [Accepted: 11/29/2021] [Indexed: 12/27/2022] Open
Abstract
Purpose To evaluate and quantify blood perfusion and retinal thickness (RT) from the perspective of quadrants by optical coherence tomography angiography (OCTA) in adolescents with myopia and explore the relationship between axial elongation and related indexes of OCTA. Methods A total of 88 subjects (149 eyes) with different degrees of myopia were included in this cross-sectional study. Vessel density (VD) and RT of quadrants in macular and peripheral regions were measured through OCTA. Results The superficial VD (SVD) of the parainferior region was significantly correlated with axial length (AL) between the emmetropia (EM) group and high myopia (HI) group (P=0.012). There were significant differences in deep VD (DVD) in all quadrants, except for the foveal, perifoveal, and peri-inferior regions (P > 0.05). However, there were significant alterations in the whole, parainferior, and perinasal regions (P=0.030, 0.023, and 0.035) in the low-to-moderate myopia (L–M) group compared with those in the HI group. There were significant differences in the RT in all quadrants, except for the foveal, paratemporal, and paranasal regions (P > 0.05) between the EM and L–M groups and the foveal region (P > 0.05) between the EM and HI groups. Nevertheless, only RT in the peri-inferior region of the L–M and HI groups showed significant differences. AL was negatively correlated with SVD in the perifoveal and parainferior regions (r = −0.179, P=0.029; r = −0.227, P=0.005) and inversely correlated with DVD and RT in almost all quadrants, except for the foveal region (r = −0.020, P=0.811; r = 0.135, P=1.000). Conclusion DVD and RT were closely associated with the severity of myopia and might be new indexes in assessing and detecting myopia development via OCTA.
Collapse
|
14
|
Jiang Y, Lou S, Li Y, Chen Y, Lu TC. High myopia and macular vascular density: an optical coherence tomography angiography study. BMC Ophthalmol 2021; 21:407. [PMID: 34836532 PMCID: PMC8626942 DOI: 10.1186/s12886-021-02156-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/04/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate whether there are differences inmacular vascular density (VD) between patients with high-myopia (HM) and those with non-high myopia (NHM) using Optical Coherence Tomography Angiography (OCTA). Method OCTA was performed on 35 eyes with HM with spherical equivalence (SE) > − 6.00D and 35 eyes with NHM with SE ≤ -6.00D. Vascular densities of the macula (overall macula, fovea, parafovea, superior hemi and inferior hemi) were measured in each of the superficial, deep and choriocapillaris layers of the retina. Results In the superficial retinal layer, overall macular VFD was significantly higher in the NHM compared to the HM group (51.27 ± 3.74 vs. 48.07 ± 5.69, p < 0.05). There were significant differences between the NHM and HM in parafovea (52.58 ± 5.78 vs. 49.4 ± 6.43, p < 0.05), superior-hemi (53.38 ± 4.03 vs 49.78 ± 6.84, p < 0.05) and inferior-hemi regions (53.49 ± 4.61 vs 49.05 ± 6.41, p < 0.05), but not in the fovea region. Similarly, in the deep retinal layer, overall macular VFD was significantly higher in the NHM group compared to the HM group (58.69 ± 2.46 vs. 56.90 ± 4.08, p < 0.05). There was significant differences between the HM and NHM in superior-hemi region (61.97 ± 2.68 vs. 60.08 ± 3.98, p < 0.05), but not in the fovea, parafovea, and inferior-hemi region. In the choriocapillaris, there was no difference in the overall macular VFD, nor any of the individual sectors between the HM and the NHM groups. Conclusion VFD in the superficial and deep retinal layers of the macula are significantly increased in the NHM compared to HM eyes. This is not the case in the choroidal capillary layers of the retina.
Collapse
Affiliation(s)
- Yang Jiang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shang Lou
- Department of Ophthalmology, Jiangxi Cancer Hospital, Nanchang Beijing ease road No.519, Jiang xi, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China. .,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Thomas Chengxuan Lu
- School of Medicine, University of New South Wales, Kensington, NSW, 2052, Australia
| |
Collapse
|
15
|
Ko CK, Huang KI, Su FY, Ko ML. Vessel Density in the Macular and Peripapillary Areas in Preperimetric Glaucoma to Various Stages of Primary Open-Angle Glaucoma in Taiwan. J Clin Med 2021; 10:jcm10235490. [PMID: 34884191 PMCID: PMC8658219 DOI: 10.3390/jcm10235490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 01/19/2023] Open
Abstract
Peripapillary and macular vessel density (VD) are reduced in myopic non-glaucomatous eyes, the dynamic range of VD may be decreased by myopia, and whether VD measurement has the potential in differentiating stages of glaucoma severity in patients with myopic glaucoma remains questionable. This observational, cross-sectional study aimed to clarify the changes in peripapillary and macular VDs in preperimetric glaucoma (PPG) and primary open-angle glaucoma in the early, moderate, and late stages. A total of 1228 eyes from 661 participants (540 normal, 67 PPG, and 521 glaucomatous) were included. Participants underwent free blood tests at the internal medicine clinic to retrieve systemic data. Patients with glaucoma were grouped by disease severity, defined by glaucomatous visual field mean defect, including early-(224 eyes), moderate-(103 eyes), and late-stage glaucoma (194 eyes), and further divided into advanced (158 eyes) and terminal glaucoma (36 eyes). Macular VD, peripapillary VD, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and ganglion cell complex (GCC) thickness were evaluated and divided into superior and inferior parts. One-way analysis of variance was performed, followed by Tukey’s post-hoc test. The peripapillary VD was significantly different between the healthy and PPG groups and the early-, moderate-, and late-stage glaucoma subgroups (all p < 0.001). Peripapillary VD measurements are helpful in differentiating the various stages of glaucoma even in patients with myopic glaucoma.
Collapse
Affiliation(s)
- Chung-Kuang Ko
- Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kuan-I Huang
- Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan;
| | - Fang-Ying Su
- Institute of Statistics, National Chiao Tung University, Hsinchu 300, Taiwan;
| | - Mei-Lan Ko
- Department of Ophthalmology, National Taiwan University Hospital, Hsinchu 300, Taiwan
- Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-965-580-725
| |
Collapse
|
16
|
Cohen SY, Vignal-Clermont C, Trinh L, Ohno-Matsui K. Tilted disc syndrome (TDS): New hypotheses for posterior segment complications and their implications in other retinal diseases. Prog Retin Eye Res 2021; 88:101020. [PMID: 34800679 DOI: 10.1016/j.preteyeres.2021.101020] [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: 08/16/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
Tilted disc syndrome (TDS) is considered a congenital anomaly due to a delayed closure of the embryonic fissure. It is characterized by an oblique orientation of the axis of the optic disc, associated with other posterior pole anomalies such as inferior crescent, situs inversus and inferior staphyloma. The aim of this review was to summarize the data supporting the current hypotheses for the pathogenesis of TDS, and its anatomical and functional clinical consequences. Recent imaging techniques, such as magnetic resonance imaging, wide-field fundus imaging, and 2- and 3-D optical coherence tomography have provided a new perspective on TDS and its complications. Different abnormalities have previously been reported, both in the anterior and posterior segments. The focus was on vision-threatening chorioretinal changes or complications, including choroidal neovascularization and serous retinal detachments and their therapeutic options. Based on clinical observations, assumptions were proposed to understand the occurrence of complications such as chorioretinal degenerative changes, choroidal neovascularization and polypoidal choroidal vasculopathy, macular serous retinal detachment, myopic foveoschisis and chorioretinal folds. These hypotheses could be referred to as the curvature "breaking point" hypothesis, the uneven growth "tractional" hypothesis, the "container-content" imbalance hypothesis, and the "choroidal funnel" hypothesis. Because these complications could also occur in other contexts, understanding the pathogenesis of TDS complications could help to understand their pathophysiology.
Collapse
Affiliation(s)
- Salomon Yves Cohen
- Ophthalmic Center of Imaging and Laser, Paris, France; Department of Ophthalmology, Intercity Hospital and University of Paris Est, Creteil, France.
| | | | - Liem Trinh
- CHNO des Quinze-Vingts, IHU Foresight, INSERM-DGOS CIC 1423, Paris, France
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
17
|
Piao H, Guo Y, Zhang H, Sung MS, Park SW. Acircularity and circularity indexes of the foveal avascular zone in high myopia. Sci Rep 2021; 11:16808. [PMID: 34413395 PMCID: PMC8376906 DOI: 10.1038/s41598-021-96304-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022] Open
Abstract
This study explored the association between foveal avascular zone (FAZ) parameters and high myopia using optical coherence tomography angiography. We divided 106 eyes of 106 patients into quartiles based on the axial length. The upper quartile was then defined as the high myopia group (n = 27), while the lower quartile was the non-high myopia group (n = 26). The areas and minor axis lengths of superficial and deep FAZ, the perimeters and major axis lengths of deep FAZ were significantly larger in eyes with high myopia than in eyes with non-high myopia (P < 0.05). Inversely, the subfoveal choroidal thickness was significantly thinner in eyes with high myopia than in those with non-high myopia. Linear regression analyses showed that no significant correlation was observed between FAZ areas and acircularity and circularity indexes of FAZ in non-high myopia group. Conversely, FAZ areas strongly correlated with acircularity and circularity indexes of FAZ in high myopia group. We found that an increase in the FAZ area in highly myopic eyes was accompanied by a significant variation in FAZ acircularity and circularity indexes. Further research should address whether these findings are associated with future disease development in highly myopic eyes.
Collapse
Affiliation(s)
- Helong Piao
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.,Department of Ophthalmology, Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, Sichuan, China
| | - Yue Guo
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haowei Zhang
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Mi Sun Sung
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Sang Woo Park
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.
| |
Collapse
|
18
|
Zhao M, Lam AK, Cheong AM. Structural and haemodynamic properties of ocular vasculature in axial myopia. Clin Exp Optom 2021; 105:247-262. [PMID: 34343434 DOI: 10.1080/08164622.2021.1943320] [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] [Indexed: 10/20/2022] Open
Abstract
The high prevalence of myopia has become a global concern, especially in East and Southeast Asia. Alarmingly, the prevalence of high myopia is increasing. Mechanical stretching caused by excessive eyeball elongation leads to various anatomical changes in the fundus. This stretching force may also lead to the development of vascular abnormalities, which tend to be subtle and easily overlooked. A healthy ocular vasculature is a prerequisite of adequate oxygen supply for normal retinal functions. This review summarises previous findings on structural and haemodynamic aspects of myopia-related vascular changes.
Collapse
Affiliation(s)
- Mei Zhao
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Andrew Kc Lam
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Allen My Cheong
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| |
Collapse
|
19
|
Associations of refractive errors and retinal changes measured by optical coherence tomography: A systematic review and meta-analysis. Surv Ophthalmol 2021; 67:591-607. [PMID: 34343537 DOI: 10.1016/j.survophthal.2021.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022]
Abstract
Studies reporting alteration in retinal thickness using optical coherence tomography (OCT) have been performed in different populations with various degrees of refractive error, producing inconsistent results. Therefore, we performed a meta-analysis to evaluate the alterations in retinal OCT measurements in myopic and hyperopic patients compared to controls. Evaluation of different retinal layers' thickness may have significance for developing novel approaches for preventing, diagnosing, and treating refractive errors and their complications. We searched PubMed and EMBASE to identify articles that reported OCT measurements of different retinal layers and regions, including macular, foveal, parafoveal, perifoveal, foveolar, ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell and inner plexiform layer (GC-IPL) thickness in addition to macular volume, and optic disc area in myopes and hyperopes comparing their differences with controls. We applied either a fixed-effects or random-effects model for the meta-analysis of these differences based on the assessed heterogeneity level. Furthermore, subgroup analyses and metaregression, as well as publication bias and quality assessment, were conducted for the eligible studies. Forty-seven studies with a total of 12223 eyes, including 8600 cases and 3623 non-cases, are included in this meta-analysis. Our results showed that, in comparison to controls, highly myopic eyes had a significantly lower value for mean macular thickness, macular GCC, macular GC-IPL, parafoveal, perifoveal, foveal, foveolar, RNFL, and pRNFL thickness. Compared to controls, moderately myopic eyes showed a significantly thinner mean macular GCC layer and pRNFL. On the other hand, hyperopic eyes had significantly thicker average pRNFL than controls. Several other significant differences were also observed in various regional analyses. The findings of the current study affirm the retinal OCT measurement differences between myopic and hyperopic eyes compared to controls, emphasizing OCT measurements' advantages as potential biomarkers of ocular pathologies.
Collapse
|
20
|
Evaluation of retinal vascular density and related factors in youth myopia without maculopathy using OCTA. Sci Rep 2021; 11:15361. [PMID: 34321564 PMCID: PMC8319333 DOI: 10.1038/s41598-021-94909-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/19/2021] [Indexed: 11/08/2022] Open
Abstract
To evaluate the retinal vascular flow density changes of myopic eyes of young adults using optical coherence tomography angiography and the factors affecting these changes. In this cross-sectional study, 90 eyes of 45 participants were analyzed and divided into three groups: mild, moderate, and high myopia (without pathological changes). Macular and radial peripapillary capillary flow densities were measured using optical coherence tomography angiography. Their relationships with the axial length, the spherical equivalent of the refractive error, and age were analyzed using analysis of variance, Pearson's correlation coefficient, and multivariate linear regression analysis. Superficial and deep macular vascular densities were significantly decreased in the high myopia group compared to the other groups. In the high myopia group, the nasal peripapillary flow density decreased, whereas the flow density inside the disc increased. The axial length negatively correlated with the superficial and deep macular vascular density, but positively correlated with the vascular density inside the disc. The spherical equivalent of the refractive error negatively correlated with the macular vascular density. The retinal vascular density decreased in the high myopia group. Hence, the microvascular network inside the disc may have a compensatory action in the hypoxic setting of high myopia.
Collapse
|
21
|
Wang XQ, Zeng LZ, Chen M, Liu LQ. A meta-analysis of alterations in the retina and choroid in high myopia assessed by optical coherence tomography angiography. Ophthalmic Res 2021; 64:928-937. [PMID: 34237732 DOI: 10.1159/000517096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 05/02/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Xiao-Qin Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Department of Ophthalmology, Chengdu Integrated TCM & Western Medicine Hospital/Chengdu First People's Hospital, Chengdu, China
| | - Liu-Zhi Zeng
- Department of Ophthalmology, Chengdu Integrated TCM & Western Medicine Hospital/Chengdu First People's Hospital, Chengdu, China
| | - Ming Chen
- Department of Ophthalmology, Chengdu Integrated TCM & Western Medicine Hospital/Chengdu First People's Hospital, Chengdu, China
| | - Long-Qian Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
22
|
Zheng F, Chua J, Ke M, Tan B, Yu M, Hu Q, Cheung CMG, Ang M, Lee SY, Wong TY, Schmetterer L, Wong CW, Hoang QV. Quantitative OCT angiography of the retinal microvasculature and choriocapillaris in highly myopic eyes with myopic macular degeneration. Br J Ophthalmol 2021; 106:681-688. [PMID: 33397658 DOI: 10.1136/bjophthalmol-2020-317632] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To quantify retinal and choriocapillaris (CC) microvasculature in highly myopic (HM) eyes with myopic macular degeneration (MMD) using swept-source optical coherence tomography angiography (SS-OCTA). METHODS 162 HM eyes (spherical equivalent ≤ -6.0 dioptres or axial length (AL) ≥26.5 mm) from 98 participants were enrolled, including 60 eyes (37.0%) with tessellated fundus, 54 eyes (33.3%) with peripapillary diffuse chorioretinal atrophy (PDCA), 27 eyes (16.7%) with macular diffuse chorioretinal atrophy (MDCA) and 21 eyes (13.0%) with patchy or macular atrophy. PLEX Elite 9000 SS-OCTA was performed to obtain perfusion densities (PD) of the superficial and deep retinal capillary plexus, and CC signal voids (number, area and density). RESULTS Retinal PD decreased with increasing severity of MMD. Multivariable analysis showed that after adjustment of age and other factors, retinal PD decreased significantly in eyes with longer AL (β≤-0.51, p<0.001) and with an MMD severity of MDCA or worse (β≤-1.63, p<0.001). Reduced retinal PD were significantly associated with worse vision (β≤-0.01, p≤0.04). In terms of CC signal voids, multivariable analysis showed that longer AL (p<0.001), but not MMD severity (p≥0.12) was significantly associated with CC signal void changes in the earliest stage of MMD. CONCLUSION We demonstrate significant OCTA alterations in the retina and CC in HM eyes with varying severities of MMD. In eyes with early-stage PDCA, lower retinal PD and more extensive CC signal voids are predominantly associated with increasing AL. In contrast, in eyes with MDCA or worse, MMD itself was associated with sparser retinal and CC circulation.
Collapse
Affiliation(s)
- Feihui Zheng
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Mengyuan Ke
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore
| | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Qinglan Hu
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Shu Yen Lee
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | | | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Institute for Health Technologies, Nanyang Technological University, Singapore.,Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Chee Wai Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore.,Department of Ophthalmology, Columbia University Medical Center, New York City, New York, USA
| |
Collapse
|
23
|
Macular and Peripapillary Optical Coherence Tomography Angiography Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data. Am J Ophthalmol 2020; 219:66-76. [PMID: 32574773 DOI: 10.1016/j.ajo.2020.06.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To identify optical coherence tomography angiography (OCTA)-derived vessel metrics of the macula and optic nerve head (ONH) that predict diabetic retinopathy (DR) disease progression. DESIGN Secondary analysis of clinical trial data. METHODS This was a sub-analysis of prospectively collected data from 73 subjects that participated in the TIME-2b study (Aerpio Pharmaceuticals), a multicenter clinical trial for patients with moderate-to-severe DR treated with AKB-9778 and followed over a 12-month period. Eligible subjects were tested every 3 months with color fundus photography, spectral-domain OCT, and slit-lamp biomicroscopy. OCTA of the macula and ONH was obtained for a subset of patients enrolled at participating sites. En face, full-depth retinal projections centered at the macula were analyzed for multiple metrics including foveal avascular zone (FAZ) area and perimeter, nonperfusion area, vessel density (VD), and presence of intraretinal microvascular abnormalities (IRMA). VD of the radial peripapillary capillaries was evaluated in 4 quadrants surrounding the optic disc for ONH images. Progression was defined as a ≥2-step increase in DR severity scale score or development of diabetic macular edema. RESULTS Over a follow-up period of 12 months, 15 of 73 (20.5%) subjects progressed. At pretreatment baseline, larger FAZ area, presence of IRMA, and reduced peripapillary VD in the superior temporal and inferior temporal regions were significantly associated with increased odds of progression. CONCLUSIONS FAZ area and temporal peripapillary VD are predictors of DR progression. OCTA metrics may improve progression risk assessment in DR when compared to established risk factors alone.
Collapse
|