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Joseph S, Robbins CB, Haystead A, Hemesath A, Allen A, Kundu A, Ma JP, Scott BL, Moore KPL, Agrawal R, Gunasan V, Stinnett SS, Grewal DS, Fekrat S. Characterizing differences in retinal and choroidal microvasculature and structure in individuals with Huntington's Disease compared to healthy controls: A cross-sectional prospective study. PLoS One 2024; 19:e0296742. [PMID: 38289919 PMCID: PMC10826956 DOI: 10.1371/journal.pone.0296742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE To characterize retinal and choroidal microvascular and structural changes in patients who are gene positive for mutant huntingtin protein (mHtt) with symptoms of Huntington's Disease (HD). METHODS This study is a cross-sectional comparison of patients who are gene positive for mHtt and exhibit symptoms of HD, either motor manifest or prodromal (HD group), and cognitively normal individuals without a family history of HD (control group). HD patients were diagnosed by Duke movement disorder neurologists based on the Unified Huntington's Disease Rating Scale (UHDRS). Fovea and optic nerve centered OCT and OCTA images were captured using Zeiss Cirrus HD-5000 with AngioPlex. Outcome metrics included central subfield thickness (CST), peripapillary retinal nerve fiber layer (pRNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, and choroidal vascularity index (CVI) on OCT, and foveal avascular zone (FAZ) area, vessel density (VD), perfusion density (PD), capillary perfusion density (CPD), and capillary flux index (CFI) on OCTA. Generalized estimating equation (GEE) models were used to account for inter-eye correlation. RESULTS Forty-four eyes of 23 patients in the HD group and 77 eyes of 39 patients in the control group were analyzed. Average GCIPL thickness and FAZ area were decreased in the HD group compared to controls (p = 0.001, p < 0.001). No other imaging metrics were significantly different between groups. CONCLUSIONS Patients in the HD group had decreased GCIPL thickness and smaller FAZ area, highlighting the potential use of retinal biomarkers in detecting neurodegenerative changes in HD.
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Affiliation(s)
- Suzanna Joseph
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Cason B. Robbins
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Alice Haystead
- iMIND Research Group, Durham, NC, United States of America
| | - Angela Hemesath
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Ariana Allen
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Anita Kundu
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Justin P. Ma
- iMIND Research Group, Durham, NC, United States of America
| | - Burton L. Scott
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States of America
| | - Kathryn P. L. Moore
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States of America
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Vithiya Gunasan
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Sandra S. Stinnett
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Dilraj S. Grewal
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
| | - Sharon Fekrat
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, United States of America
- iMIND Research Group, Durham, NC, United States of America
- Department of Neurology, Duke University School of Medicine, Durham, NC, United States of America
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Akrobetu DY, Robbins CB, Ma JP, Soundararajan S, Quist MS, Stinnett SS, Moore KPL, Johnson KG, Liu AJ, Grewal DS, Fekrat S. Intrasession Repeatability of OCT Angiography Parameters in Neurodegenerative Disease. Ophthalmol Sci 2023; 3:100275. [PMID: 36950088 PMCID: PMC10025280 DOI: 10.1016/j.xops.2023.100275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/09/2023] [Accepted: 01/20/2023] [Indexed: 02/02/2023]
Abstract
Purpose To assess the intrasession repeatability of macular OCT angiography (OCTA) parameters in Alzheimer's disease (AD), mild cognitive impairment (MCI), Parkinson's disease (PD), and normal cognition (NC). Design Cross sectional study. Subjects Patients with a clinical diagnosis of AD, PD, MCI, or NC were imaged. Images with poor quality and of those with diabetes mellitus, glaucoma, or vitreoretinal disease were excluded from analysis. Methods Intervention or Testing All participants were imaged using the Zeiss Cirrus HD-5000 with AngioPlex (Carl Zeiss Meditec, Software Version 11.0.0.29946) and repeat OCTA images were obtained for both eyes. Perfusion density (PFD), vessel density (VD), and Foveal avascular zone (FAZ) area were measured from 3 × 3 mm and 6 × 6 mm OCTA images centered on the fovea using an ETDRS grid overlay. Main Outcome Measures Intraclass correlation coefficients were used to quantify repeatability of PFD, VD, and FAZ area measurements obtained from imaging. Results 3 × 3 mm scans of 22 AD, 40 MCI, 21 PD, and 26 NC participants and 6 × 6 mm scans of 29 AD, 44 MCI, 29 PD, and 30 NC participants were analyzed. Repeatability values ranged from 0.64 (0.49-0.82) for 6 × 6 mm PFD in AD participants to 0.87 (0.67-0.92) for 3 × 3 mm PFD in AD participants. No significant differences were observed in repeatability between NC participants and those with neurodegenerative disease. Conclusions Overall, similar OCTA repeatability was observed between NC participants and those with neurodegeneration. Regardless of diagnostic group, macular OCTA metrics demonstrated moderate to good repeatability. Financial Disclosures The authors have no proprietary or commercial interest in any materials discussed in this article.
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Key Words
- AD, Alzheimer's disease
- Alzheimer
- CI, confidence interval
- D, diopters
- FAZ, Foveal avascular zone
- ICC, intraclass correlation
- MCI, mild cognitive impairment
- MSE, mean square error
- Mild cognitive impairment
- NC, normal cognition
- OCTA
- OCTA, OCT angiography
- PD, Parkinson's disease
- PFD, Perfusion density
- Parkinson
- Repeatability
- SSI, strength signal index
- VD, vessel density
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Affiliation(s)
- Dennis Y Akrobetu
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Cason B Robbins
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Justin P Ma
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Srinath Soundararajan
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Michael S Quist
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Sandra S Stinnett
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Kathryn P L Moore
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Kim G Johnson
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Andy J Liu
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Dilraj S Grewal
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Sharon Fekrat
- iMIND Research Group, Duke University School of Medicine, Durham, North Carolina
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
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