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Szydełko-Paśko U, Przeździecka-Dołyk J, Dołyk A, Małyszczak A, Misiuk-Hojło M. Evaluation of Choroidal and Retinal Features in Patients with Primary Vasculitis-An Original Optical Coherence Tomography and Optical Coherence Tomography Angiography Study. J Clin Med 2023; 12:6827. [PMID: 37959292 PMCID: PMC10648798 DOI: 10.3390/jcm12216827] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Ocular manifestations have been described in the course of various types of vasculitis. However, there seems to be no routine ophthalmological examinations for patients suffering from those diseases. To ensure holistic care we aimed to investigate any retinal and choroidal abnormalities in patients suffering from primary vasculitis. The objective was to use non-invasive methods, which would not be time- and cost-consuming, yet would be helpful in routine tests. We conducted a prospective and observational study in 41 patients (78 eyes) with 5 types of primary vasculitis, including: Takayasu's arteritis; giant cell arteritis; Buerger's disease; granulomatosis with polyangiitis; and polyarteritis nodosa. A total of 44 healthy individuals were enrolled in the control group for comparison (88 eyes). With the use of optical coherence tomography, optical coherence tomography angiography, and MATLAB, the following parameters were assessed: choroidal thickness; vascularity index; area and perimeter of foveal avascular zone; and circularity index. The following parameters were lower in the study group compared to the control group: mean nasal and temporal CTs; mean central, temporal, and nasal CVI; and mean CI. In contrast, the results of mean central CT as well as the area and perimeter of FAZ were higher in the study group. The differences were statistically significant in the case of all parameters except for CI. Conducting routine ophthalmological examinations in patients diagnosed with vasculitis by assessment of the retina and choroid by measuring parameters like CT, CVI, area and perimeter of FAZ, and CI could be beneficial, as it may detect pathological changes before any ocular symptoms alarm the patients. CVI seems to be especially promising for choroidal evaluation, as it appears to be less influenced by various factors compared to CT.
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Affiliation(s)
| | - Joanna Przeździecka-Dołyk
- Department of Optics and Photonics, Wrocław Univeristy of Science and Technology, 50-370 Wrocław, Poland
| | - Andrzej Dołyk
- Clinic of Angiology, Systemic Hypertension and Diabetology, Wrocław Teaching Hospital, 50-556 Wrocław, Poland
| | - Artur Małyszczak
- Department of Ophthalmology, Wrocław Medical University, 50-556 Wrocław, Poland
| | - Marta Misiuk-Hojło
- Department of Ophthalmology, Wrocław Medical University, 50-556 Wrocław, Poland
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AttaAllah HR, Abdelaziz STA, Mohamed AAM, Ibrahiem MFK. Assessment of macular microvascular changes in children following treatment of anisometropic myopic amblyopia using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 2023; 261:2689-2699. [PMID: 37052667 PMCID: PMC10432315 DOI: 10.1007/s00417-023-06055-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE To evaluate macular microvascular changes in the form of foveal avascular zone (FAZ) area and vessel density in the superficial, deep capillary plexuses, and choriocapillaris using optical coherence tomography angiography (OCTA) in children with anisometropic myopic amblyopia before and after treatment. METHODS This prospective observational study included 32 patients younger than 12 years old with anisomyopic amblyopia. OCTA was done before patients' treatment with optical correction with or without patching and was repeated after successful amblyopia treatment. Outcomes included superficial, deep, and choriocapillaris vessel density (VD) and superficial and deep FAZ areas. RESULTS The study included 13 males (40.6%) and 19 females (59.4%), and the mean age was 9.52 ± 1.33 years. Fifty-three percent (53%) of patients needed only optical correction, and the remaining 47% needed additional patching therapy. After successful treatment, there was a significant improvement in amblyopic eyes in best-corrected visual acuity (p < 0.001), with higher VD values in superficial capillary plexuses (p < 0.001), deep capillary plexuses (p < 0.001), and foveal choriocapillaris (p = 0.030). In the glasses with patching subgroup, the difference between pre-treatment and post-treatment parameters revealed a significant improvement in vessel density in superficial retinal plexuses (foveal and parafoveal; p values 0.023 and < 0.001, respectively) and deep retinal plexuses (whole image, foveal, and parafoveal; p values 0.003, < 0.001, and 0.002, respectively). While amblyopic eyes treated with glasses alone had a significantly greater difference in choriocapillaris foveal VD (p value = 0.022). CONCLUSION After effective amblyopia treatment, amblyopic eyes exhibited improved best-corrected visual acuity and better macular perfusion along the superficial, deep vascular density, and choriocapillaris foveal VD. CLINICAL TRIAL REGISTRATION CinicalTrials.gov Identifier: NCT05223153.
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Affiliation(s)
- Heba Radi AttaAllah
- Ophthalmology department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Sahar Torky Abdelrazik Abdelaziz
- Ophthalmology department, Faculty of Medicine, Minia University, Minia, Egypt.
- Ophthalmology department, Minia University Hospital, Minia University, Minia, 61111, Egypt.
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Storp JJ, Zimmermann JA, Danzer MF, Alnawaiseh M, Eter N, Al-Nawaiseh S. Characterizing Foveal Hypoplasia Using Optical Coherence Tomography Angiography: Evaluation of Microvascular Abnormalities and Clinical Significance. J Clin Med 2023; 12:4992. [PMID: 37568394 PMCID: PMC10419931 DOI: 10.3390/jcm12154992] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to evaluate foveal avascular zone (FAZ) features and macular flow density (FD) in various retinal layers in a cohort of patients with foveal hypoplasia (FH) using optical coherence tomography angiography (OCTA), in order to characterize microvascular abnormalities and explore their potential clinical significance. FAZ parameters and FD, as well as retinal thickness and volume values were analyzed and compared between patients with FH and an age- and gender-matched control cohort. Correlations between disease severity and visual acuity (VA), as well as between disease severity and FAZ features were evaluated. A total of 19 eyes with FH and 19 control eyes were included. The study group showed significantly higher FD values in the foveal sectors of the superficial and deep capillary plexus compared to controls. FAZ area, perimeter, and acircularity index (ACI) were noticeably altered in eyes with FH; however, they did not correlate with disease severity. Visual acuity was negatively correlated with disease severity. The results of this study provide evidence of altered microvasculature architecture specifically in the foveal sectors of patients with FH. The higher FD values in the foveal sectors of FH patients suggest a potential compensatory response of the retinal microvasculature. FAZ parameters and FD values of the foveal sectors could be used as part of an OCTA-based grading system in FH patients.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Moritz Fabian Danzer
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany;
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33604 Bielefeld, Germany;
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany; (J.A.Z.); (N.E.); (S.A.-N.)
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Lazăr AS, Stanca HT, Tăbăcaru B, Danielescu C, Munteanu M, Stanca S. Quantitative Parameters Relevant for Diabetic Macular Edema Evaluation by Optical Coherence Tomography Angiography. Medicina (Kaunas) 2023; 59:1120. [PMID: 37374324 DOI: 10.3390/medicina59061120] [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: 04/25/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Diabetic macular edema (DME) is one of the main ocular complications of diabetes mellitus (DM) that can lead to important vision loss in diabetic patients. In clinical practice, there are cases of DME with unsatisfying treatment responses, despite adequate therapeutic management. Diabetic macular ischemia (DMI) is one of the causes suggested to be associated with the persistence of fluid accumulation. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality, able to give in-depth information about retinal vascularization in a 3-dimensional manner. The OCTA devices currently available can provide various OCTA metrics that quantitatively assess the retinal microvasculature. In this paper, we reviewed the results of multiple studies that investigated the changes in OCTA metrics in the setting of DME and their possible contribution to the diagnosis, therapeutic management, follow-up and prognosis of patients with DME. We analyzed and compared relevant studies that investigated OCTA parameters related to changes in macular perfusion in the setting of DME and we evaluated the correlations between DME and several quantitative parameters, such as vessel density (VD), perfusion density (PD), foveal avascular zone (FAZ)-related parameters, as well as complexity indices of retinal vasculature. The results of our research showed that OCTA metrics, evaluated especially at the level of the deep vascular plexus (DVP), are useful instruments that can contribute to the assessment of patients with DME.
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Affiliation(s)
- Alina-Simona Lazăr
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, Strada Dionisie Lupu No. 37, 020021 Bucharest, Romania
- Clinical Department of Ophthalmology, "Prof. Dr. Agrippa Ionescu" Emergency Hospital, Strada Ion Mincu No. 7, 011356 Bucharest, Romania
| | - Horia T Stanca
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, Strada Dionisie Lupu No. 37, 020021 Bucharest, Romania
- Clinical Department of Ophthalmology, "Prof. Dr. Agrippa Ionescu" Emergency Hospital, Strada Ion Mincu No. 7, 011356 Bucharest, Romania
| | - Bogdana Tăbăcaru
- Clinical Department of Ophthalmology, "Prof. Dr. Agrippa Ionescu" Emergency Hospital, Strada Ion Mincu No. 7, 011356 Bucharest, Romania
| | - Ciprian Danielescu
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", Strada Universitatii No. 16, 700115 Iasi, Romania
| | - Mihnea Munteanu
- Department of Ophthalmology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Simona Stanca
- Clinical Department of Pediatrics, University of Medicine and Pharmacy "Carol Davila", Strada Dionisie Lupu No. 37, 020021 Bucharest, Romania
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Romozzi M, Cuffaro G, Rollo E, Mattei R, Marcelli S, Rizzo S, Calabresi P, Servidei S, Savino G, Vollono C. Microvascular involvement in migraine: an optical coherence tomography angiography study. J Neurol 2023:10.1007/s00415-023-11697-z. [PMID: 37154891 DOI: 10.1007/s00415-023-11697-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the microvasculature of the macula and the optic nerve in patients affected by migraine with aura (MA) and without aura (MO) by optical coherence tomography angiography (OCTA), comparing the findings with healthy controls (HC). METHODS We collected data from ocular and orthotic examinations, including eye motility, intraocular pressure measurement, best-corrected visual acuity (BCVA) measurement, objective refraction measurement, fundus examination, macular and optic disk OCTA examination. All subjects were imaged with solix fullrange OCT. The following OCTA parameters were recorded: macular vessel density (VD), inside disc VD, peripapillary VD, disc whole image VD, fovea choriocapillaris VD, fovea VD, parafovea VD, peripapillary thickness, fovea thickness, parafovea thickness, macular full retinal thickness, and foveal avascular zone (FAZ) parameters. Clinical and demographical data about migraine patients were collected by a neurologist. RESULTS We included 56 eyes from 28 patients with a diagnosis of MO, 32 eyes from 16 patients with a diagnosis of MA, and 32 eyes from 16 HC subjects. The FAZ area was 0.230 ± 0.099 mm2 in the MO group, 0.248 ± 0.091 mm2 in the MA group and 0.184 ± 0.061 mm2 in the control group. The FAZ area was significantly larger in the MA group than in the HC group (p = 0.007). The foveal choriocapillaris VD was significantly lower in MA patients (63.6 ± 2.49%) when compared with MO patients (65.27 ± 3.29%) (p = 0.02). CONCLUSION An impairment of retinal microcirculation can be detected in patients with MA, as demonstrated by the enlargement of FAZ. Moreover, the study of choroid circulation may reveal microvascular damage in patients with migraine with aura. OCTA is a useful non-invasive screening tool for the detection of microcirculatory disturbance in patients with migraine.
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Affiliation(s)
- Marina Romozzi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Cuffaro
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eleonora Rollo
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberta Mattei
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sofia Marcelli
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stanislao Rizzo
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Serenella Servidei
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurofisiopatologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Gustavo Savino
- Oculistica, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Catello Vollono
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurofisiopatologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Hoshiyama K, Hirano T, Hirabayashi K, Wakabayashi M, Tokimitsu M, Murata T. Morphological Changes in the Foveal Avascular Zone after Panretinal Photocoagulation for Diabetic Retinopathy Using OCTA: A Study Focusing on Macular Ischemia. Medicina (Kaunas) 2022; 58. [PMID: 36556999 DOI: 10.3390/medicina58121797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
Background and objectives: This study aimed to analyze the morphological changes in the foveal avascular zone (FAZ) after panretinal photocoagulation (PRP) in patients with diabetic retinopathy, with a particular focus on the presence or absence of comorbid diabetic macular ischemia (DMI), using optical coherence tomography angiography (OCTA). Materials and Methods: Treatment-naïve 25 eyes of 16 patients who received PRP were examined in this retrospective case series. FAZ area, perimeter, and circularity were calculated on a 3 × 3-mm en-face OCTA image before PRP (baseline) and 1 and 3 months after PRP. The patients were divided into two groups according to coexisting DMI, and each group was statistically analyzed. Results: In patients with DMI (9 eyes), FAZ area significantly decreased from the baseline to 3 months after PRP (0.86 ± 0.56 to 0.61 ± 0.31 mm2, p = 0.018), whereas FAZ perimeter and circularity remained unchanged following treatment (p = 0.569 and 0.971, respectively). In patients without DMI (16 eyes), FAZ parameters did not show statistically significant changes across the 3-month follow-up period. Conclusion: PRP significantly reduces FAZ area in patients with DMI.
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Oliverio GW, Meduri A, De Salvo G, Trombetta L, Aragona P. OCT Angiography Features in Diabetes Mellitus Type 1 and 2. Diagnostics (Basel) 2022; 12:diagnostics12122942. [PMID: 36552948 PMCID: PMC9777069 DOI: 10.3390/diagnostics12122942] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose: To study the foveal avascular zone (FAZ) and the vessel densities (VD) in diabetic patients using optical coherence tomography angiography (OCT-A) and inner retinal layer changes to compare patients affected by type 1 diabetes (DM1) and type 2 diabetes (DM2). Methods: Cross-sectional observational study involving 150 eyes of 150 patients with DM1, and 155 eyes of 155 patients with DM2 with diabetic retinopathy (DR). Retinal nerve fiber layer (RNFL) and Ganglion cell layer (GCL) were evaluated. OCT-A studied both FAZ and VD at the level of the superficial capillary plexus (SCP) and the deep capillary plexus (DCP). Results: A statistically significant difference in FAZ area and foveal VD measured at the SCP (p < 0.001) was noted between DM1 and DM2 groups when comparing patients with mild and moderate non-proliferative diabetic retinopathy (NPDR), while no differences were found in the severe NPDR and proliferative diabetic retinopathy (PDR) subgroups. Duration of diabetes and stage of DR were directly correlated with enlargement of FAZ area and inversely correlated with foveal VD measured at SCP. RNFL and GCL were not different between DM1 and DM2 groups. Conclusion: Changes in OCT-A parameters detected in FAZ area and VD of diabetic patients with different stages of DR may help to predict the risk for progression of the disease.
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Affiliation(s)
| | - Alessandro Meduri
- Department of Biomedical Science, Ophthalmology Clinic, University of Messina, 98124 Messina, Italy
- Correspondence: ; Tel.: +39-09022173
| | - Gabriella De Salvo
- Ophthalmology Department, University Hospital Southampton, Southampton SO16 5YA, UK
| | - Luigi Trombetta
- Department of Biomedical Science, Ophthalmology Clinic, University of Messina, 98124 Messina, Italy
| | - Pasquale Aragona
- Department of Biomedical Science, Ophthalmology Clinic, University of Messina, 98124 Messina, Italy
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Wylęgała A, Szkodny D, Fiolka R, Wylęgała E. Assessment of the Retinal Vessels in Keratoconus: An OCT Angiography Study. J Clin Med 2022; 11. [PMID: 35683349 DOI: 10.3390/jcm11112960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023] Open
Abstract
This study investigated vascular density and foveal avascular zone (FAZ) parameters using optical coherence tomography angiography (OCT-A) in patients with keratoconus (KC). Participants with KC and healthy controls were included and underwent best-corrected visual acuity (BCVA), keratometry, anterior segment OCT, and macular OCT-A examinations. Of the 70 subjects (mean age 42.9 ± 15.31 years), 79 KC and 47 healthy eyes were included. Significant reductions in the KC group were recorded for the FAZ area, with a mean (±SD) of 0.19 ± 0.12 vs. 0.25 ± 0.09 mm2 p < 0.001. Central vascular density in KC patients was lower compared with the controls: 6.78 ± 4.74 vs. 8.44 ± 3.33 mm−1 p = 0.049; the inner density was also decreased in the study group (13.64 ± 5.13 vs. 16.54 ± 2.89 mm−1, p = 0.002), along with the outer density (14.71 ± 4.12 vs. 16.88 ± 2.42 mm−1, p = 0.004) and full density (14.25 ± 4.30 vs. 16.57 ± 2.48) p = 0.003. Furthermore, BCVA was positively correlated with central vascular density (R = 0.42 p = 0.004, total R = 0.40, p = 0.006) and inner density (R = 0.44, p = 0.002) in patients with KC but not in controls. Additionally, we found a correlation between K2 and inner vascular density (R = −0.30, p = 0.043) and central epithelium thickness and outer density (R = 0.03, p = 0.046). KC patients had lower macular vascular density and a smaller FAZ than healthy participants. The BCVA in KC patients was correlated with the vascular density.
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Teo KYC, Invernizzi A, Staurenghi G, Cheung CMG. COVID-19-Related Retinal Micro-vasculopathy - A Review of Current Evidence. Am J Ophthalmol 2022; 235:98-110. [PMID: 34587494 PMCID: PMC8465265 DOI: 10.1016/j.ajo.2021.09.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the occurrence of retinal microvasculopathy in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who developed coronavirus disease (COVID-19). DESIGN Systematic review and meta-analysis. METHODS The Pubmed and Embase databases were comprehensively searched to identify studies that reported retina vascular changes in eyes with COVID-19. Two independent reviewers selected papers and extracted data for analysis. Data of interest were extracted and analyzed in RevMan Web versions 3.3. Quality of evidence was assessed using the National Institute of Health quality assessment tool for a case-control study. RESULTS Thirty-one studies reporting on 1373 subjects (972 COVID-19 and 401 controls) were included. Only case-control studies were included in the pooled analysis. There was a significantly higher likelihood of retinal microvasculopathy in subjects with COVID-19 compared to controls (odds ratio [95% confidence interval], 8.86 [2.54-27.53], P < .01). Optical coherence tomography angiography (OCTA) revealed reduced vessel density and enlarged foveal avascular zone in subjects with COVID-19 compared to controls. CONCLUSIONS The results suggested that COVID-19-related retinal microvasculopathy is a significant ocular manifestation of COVID-19 and may herald future retinal complications. These microvascular impairments might have occurred antecedent to clinically visible changes and could be detected earlier by OCTA. These findings are significant, due to the large numbers with COVID-19, and need to be recognized by ophthalmologists as a potential long-term sequalae of the disease.
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Affiliation(s)
- Kelvin YC Teo
- From the Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore (K.Y.C.T, C.M.G.C),Duke-NUS Medical School, National University of Singapore, Singapore (K.Y.C.T, C.M.G.C),Save Sight Institute, The University of Sydney, Faculty of Health and Medicine, Sydney, New South Wales, Australia (K.Y.C.T, A.I)
| | - Alessandro Invernizzi
- Save Sight Institute, The University of Sydney, Faculty of Health and Medicine, Sydney, New South Wales, Australia (K.Y.C.T, A.I),Eye Clinic, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Italy (A.I, G.S)
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Italy (A.I, G.S)
| | - Chui Ming Gemmy Cheung
- From the Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore (K.Y.C.T, C.M.G.C); Duke-NUS Medical School, National University of Singapore, Singapore (K.Y.C.T, C.M.G.C).
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Doğan M, Akdoğan M, Alizada A, Eroğul Ö, Sabaner MC, Gobeka HH, Gülyeşil FF, Seylan MA. Impacts of Camellia sinensis fermentation end-product (black tea) on retinal microvasculature: an updated OCTA analysis. J Sci Food Agric 2021; 101:6265-6270. [PMID: 33934371 DOI: 10.1002/jsfa.11294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/28/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Tea, second only to water, is one of the most regularly consumed drinks in the world. Its potentially beneficial effects on general health may be enormously important. Optical coherence tomography angiography (OCTA) now allows clinicians to examine the acute retinal morphological changes caused by black tea consumption. The purpose of this study was to investigate the acute impacts of a Camellia sinensis fermentation end-product (black tea) on retinal microvasculature in healthy individuals using OCTA. RESULTS In this study, 60 healthy people were divided into two groups: group 1 (n = 30) received black tea (2 mg/250 mL of water) and group 2 (n = 30) received only 250 mL of water. Following consumption, AngioVue Analytics software automatically analyzed the foveal, parafoveal, perifoveal macular superficial and deep vascular plexus densities, foveal avascular zone (FAZ) area, FAZ perimeter and foveal vessel density in a 300 μm wide region around the FAZ (FD-300). Male-to-female ratios were 19:11 and 15:15 in groups 1 and 2, respectively (P = 0.217). Mean age was 33.27 ± 7.92 years in group 1 and 31.00 ± 7.30 years in group 2 (P = 0.254). Changes in foveal, perifoveal and parafoveal macular vessel density between groups 1 and 2 were not statistically significant. In addition, no significant differences regarding FAZ, FAZ perimeter and FD-300 were observed. CONCLUSION There were no acute effects of black tea on macular microcirculation in healthy individuals. The authors, however, believe that this study could serve as a model for future research on the relationship between regular tea consumption and general ocular physiology. © 2021 Society of Chemical Industry.
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Affiliation(s)
- Mustafa Doğan
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Müberra Akdoğan
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Anar Alizada
- Ermeneke State Hospital, Ophthalmology Clinic, Karaman, Turkey
| | - Özgür Eroğul
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Mehmet Cem Sabaner
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hamidu Hamisi Gobeka
- Department of Ophthalmology, Agri Ibrahim Cecen University Faculty of Medicine, Ağrı, Turkey
| | - Furkan Fatih Gülyeşil
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Mehmet Akif Seylan
- Istanbul Kanuni Sultan Suleyman Educational and Research Hospital Ophthalmology Clinic, Istanbul, Turkey
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Lommatzsch C, Bauermann P, Heimes-Bussmann B, Nolte C, Heinz C. Optical Coherence Tomography Angiography in Uveitic Glaucoma - A Pilot Study. Ocul Immunol Inflamm 2021; 29:1410-1416. [PMID: 33185500 DOI: 10.1080/09273948.2020.1745246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose: To compare vessel density (VD) as measured by optical coherence tomography angiography (OCTA), in uveitic eyes with secondary glaucoma (UG) with VD in uveitic eyes without glaucoma (UV), eyes with primary open-angle glaucoma (POAG), and healthy eyes (HY).Methods: VD was measured at the following segmentation areas: radial peripapillary capillaries, superficial (SL) and deep vascular plexus (DL) and choroid.Results: The majority of the measured papillary areas showed significantly lower VD in the UG group than in the HY group. In macular area, in the superficial vascular plexus wholeVD was significantly lower than in the healthy group, as well as in four other quadrants. In DL no significant differences could be found. At choroidal level, the VD of UG group were significantly lower in two quadrants than in UV group.Conclusions: OCTA can be used to detect differences in VD in papillary and macular region of uveitis glaucoma eyes.
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Affiliation(s)
- C Lommatzsch
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - P Bauermann
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - B Heimes-Bussmann
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - C Nolte
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - C Heinz
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany.,Department of Ophthalmology, University of Essen, Essen, Germany
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AttaAllah HR, Mousa SO, Omar IAN. Macular microvascular changes in children with transfusion-dependent beta-thalassemia. Graefes Arch Clin Exp Ophthalmol 2021; 259:3283-3293. [PMID: 34125290 DOI: 10.1007/s00417-021-05275-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/29/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND To investigate the effect of iron overload on macular perfusion among transfusion-dependent thalassemia (TDT) patients using optical coherence tomography angiography (OCTA) METHODS: The study is a prospective observational case-control study. It included 27 eyes from 27 children with transfusion-dependent β-thalassemia and 25 eyes from 25 age-matched controls. All participants were evaluated clinically and with OCTA Avanti RTVue-XR system (Optovue) to assess macular microvascular changes, by measuring vessels density (VDs) and foveal avascular zone (FAZ) area, at both superficial and deep retinal plexuses and at choriocapillaris level. RESULTS Foveal and parafoveal zones were significantly thinner among thalassemia patients, with significantly larger FAZ area at the level of both superficial and deep retinal plexuses when compared with control group. The thalassemia group showed significant lower values compared with the controls regarding whole-image, foveal, and parafoveal deep VD. There were significant negative correlations between serum ferritin and deep (whole image and parafoveal) VD (r = - 0.429, P = 0.026, and r = - 0.452, P = 0.018, respectively). Choriocapillaris VDs (whole image and foveal) showed significant negative correlations with serum ferritin levels (r = - 0.390, P = 0.044 and r = - 0.401, P = 0.038, respectively) CONCLUSIONS: Macular microvascular changes were detected by OCTA examination in patients with TDT, mostly due to iron overload effect, as we selected patients on iron-chelating agent with the least harmful effect on the retina. The most affected layer is the DCP. Changes at the deep layer could be used as a sensitive biomarker for early macular perfusion changes in those patients. TRIAL REGISTRATION Study registration number is UMIN000042657, date of registration: 2020/12/04 (retrospectively registered).
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Bahadir Akkoc S, Kazim Erol M, Suren E. Macular microvascular changes in resolved central serous chorioretinopaty using spectral-domain optical coherence tomography angiography. J Fr Ophtalmol 2021; 44:693-702. [PMID: 33896657 DOI: 10.1016/j.jfo.2020.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate microvascular changes in the retina and choriocapillaris in central serous chorioretinopathy (CSCR) patients with resolved serous detachment using optical coherence tomography angiography (OCTA). METHOD 49 eyes of 46 patients with CSCR were included in the study. 32 eyes of 16 age-matched controls were included in the control group. Fundus photography, fluorescein angiography, spectral-domain optical coherence tomography and OCTA were used. Choriocapillaris (CC) flow area, foveal avascular zone (FAZ), parafoveal vascular density of superficial and deep capillary plexus of the acute and chronic CSCR groups were compared with the values of the control group. Contrary to previous studies, OCTA data were obtained at a time when there was no serous detachment. This was because we aimed at minimizing erroneous measurements that might arise due to serous detachment. RESULTS 1- The acute CSCR patients (1.705±0.292mm2) were found to have lower choriocapillaris (CC) flow area compared to the control group (2.155±0.069mm2). (P<0.001). Lower CC flow area was found in the chronic CSCR patients (1.774±0.216mm2) compared to the control group (2.155±0.069mm2) (P<0.001). 2- Chronic CSCR patients (49.27%±3.84) had a lower parafoveal density in the superficial capillary plexus compared to the control group (52.25%±2.85) (P<0.05). 3- No statistically significant difference was found between the acute CSCR group (55.07%±6.29) and chronic CSCR group (52.65%±5.18) in terms of parafoveal density in the deep capillary plexus when individually compared to the control group (53.34%±2.7). 4-A positive correlation was found between the parafoveal density in the deep capillary plexus and central foveal thickness (CFT) in the chronic CSCR group (r=0.382) (P˂0.05) 5- No statistically significant difference was found in the FAZ of the acute CSCR group (0.258±0.054mm2) and chronic CSCR group (0.342±0.124mm2) when individually compared to the control group (0.311±0.1mm2). The largest mean FAZ area was found in the chronic CSCR group. CONCLUSION Our study showed that the pathogenesis of CSCR is characterized by choriocapillaris and retinal microvascular changes.
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Aboud SAA, Hammouda LM, Saif MYS, Ahmed SS. Effect of smoking on the macula and optic nerve integrity using optical coherence tomography angiography. Eur J Ophthalmol 2021; 32:436-442. [PMID: 33567885 DOI: 10.1177/1120672121992960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the effect of chronic smoking on the macula and optic nerve integrity using optical coherence tomography angiography (OCTA). METHODS This prospective, comparative study involved the right eyes of 160 healthy subjects (80 smokers group, and 80 control group). OCTA scanning was performed for all subjects. All macular subfields thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, superficial and deep macular vessel density, foveal avascular zone (FAZ) area, and the macular outer retina flow area, were measured and analyzed. RESULTS The thickness of some macular subfields, inferior GCC, and RNFL was statistically significantly lower in the smokers' group (p < 0.05). The FAZ area was 0.409 ± 0.048 mm2 in the smokers' group and 0.327 ± 0.055 mm2 in the control group (p < 0.001). The superficial foveal VD was 31.35 ± 5.79% in the smokers' group and 33.63 ± 4.78% in the control group (p = 0.06). The deep foveal VD was 39.38 ± 4.56% in the smokers' group and 34.15 ± 6.57% in the control group (p ≤ 0.001). The superficial and deep parafoveal VD was 52.09 ± 4.56% and 59.99 ± 2.25% respectively in the smokers' group, and 54.75 ± 2.30% and 55.58 ± 4.69% respectively in the control group (p < 0.05). The macular outer retina flow area was 1.29 ± 0.12 mm2 in the smokers' group and 1.16 ± 0.11 mm2 in the control group (p < 0.001). CONCLUSION Chronic smoking affected the integrity of the macula and optic nerve. It decreased the macular VD, enlarged the FAZ, and increased outer retinal flow area.
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Chatziralli I, Theodossiadis G, Chatzirallis A, Dimitriou E, Parikakis E, Theodossiadis P. Evolution of macular microvasculature and retinal layers alterations in patients with macula off retinal detachment after vitrectomy. Eur J Ophthalmol 2021; 32:520-526. [PMID: 33550843 DOI: 10.1177/1120672121992984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the changes in retinal microvasculature in association with retinal layers' condition in patients with rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). METHODS Participants in this study were 89 patients with macula off RRD, who were successfully treated with PPV and gas tamponade without internal limiting membrane peeling, in two centers. All participants underwent best corrected visual acuity (BCVA) measurement, slit-lamp examination, fundoscopy, spectral domain-optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) at week 5, month 3 and month 6 postoperatively. The fellow untreated eyes were also examined and served as control data. RESULTS A statistically significant enlargement in foveal avascular zone (FAZ) in both superficial capillary plexus (SCP) and deep capillary plexus (DCP), accompanied with a statistically significant thinning of inner retinal layers, was noticed 5 weeks postoperatively. These changes, namely FAZ enlargement and thinning of inner retinal layers, in the operated eyes compared to the fellow eyes, remained unchanged till month 6 postoperatively. BCVA improved significantly from week 5 to months 3 and 6 postoperatively. The improvement in BCVA was associated with the gradual ellipsoid zone (EZ) recovery from the first (week 5) till the last examination (month 6). CONCLUSIONS The FAZ enlargement in the operated eyes was accompanied with a statistically significant thinning in the inner retinal layers. Inter-correlation of BCVA and EZ integrity was noticed.
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Affiliation(s)
| | | | | | - Eleni Dimitriou
- Department of Ophthalmology, University of Athens, Athens, Greece
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Maqsood S, Elalfy M, Abdou Hannon A, Hegazy SM, Elborgy ES. Functional and Structural Outcomes at the Foveal Avascular Zone with Optical Coherence Tomography Following Macula off Retinal Detachment Repair. Clin Ophthalmol 2020; 14:3261-3270. [PMID: 33116377 PMCID: PMC7568611 DOI: 10.2147/opth.s271944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022] Open
Abstract
Background Visual recovery following macula involving rhegmatogenous retinal detachment remains poorly understood. The aim of this work is to correlate the functional and the anatomical changes in retinal vasculature in the foveal avascular zone using optical coherence tomography angiography (OCTA) after successful retinal reattachment repair and correlate this data with retinal thickness and post-operative visual recovery. Methods A prospective, comparative observational study of 28 eyes of 14 patients with 14 eyes undergoing macula off retinal detachment repair with pars plana vitrectomy, endo-laser and silicone oil-based tamponade compared with 14 fellow healthy eyes at 1, 6 and 12 weeks post-operative period. The study was conducted at the Research Institute of Ophthalmology, Giza, Egypt between February 2018 and August 2018. Results The foveal avascular zone (FAZ) area in the patients group was not significantly different compared to the control group and was found to be negatively correlated with the central retinal thickness in both the study and control group. The superficial capillary plexus (SCP) area at the FAZ was significantly larger than the deep capillary plexus (DCP) area at the FAZ in both the study and control group over the follow-up period. The DCP area at the FAZ was significantly larger at the 3rd follow-up than the 1st follow-up. The SCP FAZ area was significantly larger than the DCP FAZ area in both the study and control group over the follow-up period. BCVA was found to be negatively correlated to the retinal thickness of the temporal 3 mm paracentral quadrant with no correlation with central foveal thickness (CFT) and the FAZ area. Conclusion Optical coherence tomography (OCT) and OCTA are valuable noninvasive imaging tools to monitor and predict the structural changes at the foveal avascular zone during the recovery phase after successful retinal reattachment involving macula.
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Affiliation(s)
| | - Mohamed Elalfy
- Queen Victoria Hospital, East Grinstead, UK.,Research Institute of Ophthalmology, Giza, Egypt.,Maidstone and Tunbridge Wells Hospitals, Tunbridge Wells, UK
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Magera L, Krásný J, Pluhovský P, Holubová L. CHANGES OF THE FOVEAL AVASCULAR ZONE AND MACULAR MICROVASCULATURE WITHIN THE FRAMEWORK OF OCT ANGIOGRAPHY EXAMINATION IN YOUNG PATIENTS WITH TYPE 1 DIABETES (PILOT STUDY). Cesk Slov Oftalmol 2020; 76:111-117. [PMID: 33126806 DOI: 10.31348/2020/19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM Learn about the development and changes in foveal avascular zone (FAZ) and vascularity of retina in the surrounding zone, depending on the duration in young diabetic patients type 1 (T1DM). METHODS As part of regular one-year examinations of young T1DM patients at the Eye Clinic of the University Hospital Královské Vinohrady in Prague (Czech Republic, EU) from January to December 2019, OCT angiography using the device Spectralis (Heidelberg Engineering) was included. Forty patients aged 18 to 30 years were examined, median 21 years. T1DM was diagnosed in childhood and lasted for more than 10 years. At the same time, a control group of forty individuals of similar age, without metabolic and other general disease was examined, normal visual acuity and physiological fundoscopic finding were obligatory. The FAZ size was evaluated in both groups (using built-in function "Draw Region"), also its shape, density decrease and change in character of vascularity of the retina was assessed. RESULTS In the control group, the FAZ area ranged from 0.06 to 0.4 mm², with an average of 0.253 ± 0.092 mm² and a median of 0.27 mm². It was not affected by a fundamental change in its round shape and the surrounding capillary netting was regular and reasonably dense. In T1DM patients, the FAZ area was in a wider range, from 0.05 to 0.64 mm², an average of 0.300 ± 0.132 mm², and a median of 0.31 mm². The difference in FAZ across-the-board evaluation was statistically significant (p = 0, 009). Diabetic preretinopathy (DpR) was defined by the irregularity of the capillary density up to the manifestation of non-perfusion, in 61% of cases the size of the FAZ was changed. In diabetic retinopathy (DR) there was always an irregularity of the FAZ shape with its enlargement, manifestation of non-perfusion, capillary dilatation and rare microaneurysms. CONCLUSION Changes in FAZ size corresponded to the stage of T1DM on the fundoscopic finding of the eye depending on its duration. The initial increased amount of foveal capillaries, which resulted in decreased FAZ area, was followed by a gradual decrease in capillaries and increased FAZ area, consistent with the manifestations of DpR. It was accompanied by a change in capillary density in macula to eventual non-perfusion. On the contrary, the increase in the FAZ area and its irregularity accompanied by non-perfusion of the capillary net and microaneurysms corresponded to the development of DR already.
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Abstract
BACKGROUND The foveal avascular zone (FAZ) has often been analyzed under different aspects in the last decades, mainly by fluorescence angiography (FA); however, the novel technology of optical coherence tomography angiography (OCTA) enables a non-invasive examination, visualization and quantitative analysis of the FAZ, which has recently led to many new findings, especially in a multidisciplinary manner. This article provides an overview of the investigation of the FAZ using OCTA and the new findings that have been obtained using OCTA in recent years. METHODS This article is based on a comprehensive literature review. RESULTS In many studies a good reproducibility and repeatability of the FAZ measurements by OCTA could be proven, also by comparing different OCTA devices. In patients with ocular pathologies and systemic diseases, e. g. after retinal vein occlusion or retinal surgery and in patients with diabetes mellitus without diabetic retinopathy, differences to healthy control groups and correlations to visual function could be shown. Moreover, in patients with neurological diseases, such as Alzheimer's dementia, changes of the FAZ could be identified. CONCLUSION The OCTA is a non-invasive technology, which enables a reliable visualization and reproducible quantification of the FAZ. The size of the FAZ seems to be altered in different retinal and systemic diseases, which also may correlate with visual function; however, long-term studies evaluating the diagnostic value of these changes in the course of the disease are currently lacking.
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Mirshahi A, Ghassemi F, Fadakar K, Mirshahi R, Bazvand F, Riazi-Esfahani H. Effects of panretinal photocoagulation on retinal vasculature and foveal avascular zone in diabetic retinopathy using optical coherence tomography angiography: A pilot study. J Curr Ophthalmol 2019; 31:287-91. [PMID: 31528763 DOI: 10.1016/j.joco.2019.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/20/2019] [Accepted: 06/09/2019] [Indexed: 02/03/2023] Open
Abstract
Purpose To evaluate the optical coherence tomography angiography (OCTA) parameters in patients with diabetic retinopathy following panretinal photocoagulation (PRP). Methods Eleven eyes of 6 patients with very severe nonproliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR) were recruited in this prospective interventional pilot study. All patients underwent OCTA imaging at baseline, and choroidal flow, foveal avascular zone (FAZ), retinal thickness, and vascular density were measured at baseline. Three months after treatment, OCTA was repeated, and the alteration in variables was analyzed. Results The FAZ area remained unchanged following treatment, (P = 0.75). Retinal thickness increased along (P = 0.02) with an increase in vascular density in the superficial and deep foveal area and the macular temporal sector (P = 0.007, 0.03 and 0.049, respectively). Choroidal flow surface area was unchanged (P = 0.10). Conclusion In this study, foveal vascular density increased and FAZ remained unchanged after PRP for diabetic retinopathy.
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Niestrata-Ortiz M, Fichna P, Stankiewicz W, Stopa M. Enlargement of the foveal avascular zone detected by optical coherence tomography angiography in diabetic children without diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2019; 257:689-697. [PMID: 30824996 DOI: 10.1007/s00417-019-04264-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/02/2019] [Accepted: 02/09/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Evaluation of foveal avascular zone (FAZ) in children with diabetes (DM) using OCTA. METHODS We examined 112 diabetic children without DR aged 6-18 years and 30 age-matched controls using Topcon OCT Angiography and measured FAZ in superficial (SCP) and deep capillary plexus (DCP). The study group was divided into three subgroups depending on DM duration group 1: < 5 years (n = 40), group 2: 5-10 years (n = 42), group 3: > 10 years (n = 30). RESULTS The mean DCP FAZ increased with DM duration from 502.2 μm2 (SD 137.8) in group 1 to 523.9 μm2 (SD 159.2) in group 2 and 539.7 μm2 (SD 189.1) in group 3. Control group differed significantly from group 1 (p = 0.0120), group 2 (p = 0.0019) and group 3 (p = 0.0011). The mean DCP to SCP FAZ surface ratio was 1.88 (SD 0.68) in the study vs 1.58 (SD 0.48) in the control group (p = 0.0232). The DCP and SCP FAZ surface difference was 217.6 μm2 (SD 100.8 μm2) in diabetics vs. 124.2 μm2 (SD 72.8 μm2) in controls (p < 0.0001). In the control group, it was significantly smaller than in group 1 (p < 0.006), group 2 (p < 0.0001) and group 3 (p < 0.0001). CONCLUSIONS Changes can be detected in FAZ of diabetic children before DR development which can be vital for screening.
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Affiliation(s)
| | - Piotr Fichna
- Department of Paediatric Diabetes and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Witold Stankiewicz
- Department of Paediatric Diabetes and Obesity, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland
| | - Marcin Stopa
- Department of Ophthalmology, Chair of Ophthalmology and Optometry. Heliodor Swiecicki University Hospital, Poznan University of Medical Sciences, 16/18 Grunwaldzka Street, 60-780, Poznan, Poland
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Ye H, Zheng C, Lan X, Zhao L, Qiao T, Li X, Zhang Y. Evaluation of retinal vasculature before and after treatment of children with obstructive sleep apnea-hypopnea syndrome by optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 2018; 257:543-548. [PMID: 30539310 DOI: 10.1007/s00417-018-04207-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/06/2018] [Accepted: 11/29/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To evaluate the effect of adenoidectomy on the brains of children with obstructive sleep apnea-hypopnea syndrome (OSAS) through observation of the alteration of retinal perfusion by optical coherence tomography angiography (OCTA). METHODS Sixty-two children with OSAS (124 eyes; 5.94 ± 1.64 years old; 53.2% boys) were enrolled in this study. Their retinal vascular network density indices, including vascular diameter (VD), vascular area density (VAD), vessel skeleton density (VSD), vessel perimeter index (VPI) on the macular superficial/deep capillary plexus (SCP/DCP), and the size of the foveal avascular zone (FAZ) were analyzed by OCTA before treatment and at 1 month after the adenoidectomy. RESULTS After the adenoidectomy, the values of VD, VAD, VSD, and VPI in the SCP/DCP of the parafovea were significantly increased (p < 0.01). The FAZ was significantly diminished in the SCP (t = 4.50, p < 0.05) and increased in the DCP (t = - 4.43, p < 0.05). The peripapillary indices in the SCP/DCP were not significantly changed (p > 0.05). CONCLUSION By improvement of hypoxia, the response of the parafoveal vessels was more sensitive than that of the peripapillary region in children with OSAS. Therefore, OCTA may be an ideal method to evaluate the changes of the retinal vascular system, which could be an effective parameter for the early evaluation of adenoidectomy on cases of pediatric OSAS.
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Affiliation(s)
- Haiyun Ye
- Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Ce Zheng
- Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Xiaoping Lan
- Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Limin Zhao
- Department of Otolaryngology Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Tong Qiao
- Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.
| | - Xiaoyan Li
- Department of Otolaryngology Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Yidan Zhang
- Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China
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23
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Ghassemi F, Mirshahi R, Bazvand F, Fadakar K, Faghihi H, Sabour S. The quantitative measurements of foveal avascular zone using optical coherence tomography angiography in normal volunteers. J Curr Ophthalmol 2017; 29:293-299. [PMID: 29270477 PMCID: PMC5735238 DOI: 10.1016/j.joco.2017.06.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/07/2017] [Accepted: 06/13/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose To provide normative data of foveal avascular zone (FAZ) and thickness. Methods In this cross-sectional study both eyes of each normal subject were scanned with optical coherence tomography angiography (OCTA) for foveal superficial and deep avascular zone (FAZ) and central foveal thickness (CFT) and parafoveal thickness (PFT). Results Out of a total of 224 eyes of 112 volunteers with a mean age of 37.03 (12–67) years, the mean superficial FAZ area was 0.27 mm2, and deep FAZ area was 0.35 mm2 (P < 0.001), with no difference between both eyes. Females had a larger superficial (0.32 ± 0.11 mm2 versus 0.23 ± 0.09 mm2) and deep FAZ (0.40 ± 0.14 mm2 versus 0.31 ± 0.10 mm2) (P < 0.001) than males. By multivariate linear regression analysis, in normal eyes, superficial FAZ area varied significantly with the gender, CFT, and deep FAZ. Deep FAZ varied with the gender and CFT. Conclusion The gender and CFT influence the size of normal superficial and deep FAZ of capillary network.
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Affiliation(s)
- Fariba Ghassemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Retina & Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mirshahi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bazvand
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Fadakar
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Houshang Faghihi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Sabour
- Safety Promotion and Injury Prevention Research Center, Department of Clinical Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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24
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Moreira BP, Fonseca CK, Hammarton TC, Baqui MMA. Giant FAZ10 is required for flagellum attachment zone stabilization and furrow positioning in Trypanosoma brucei. J Cell Sci 2017; 130:1179-1193. [PMID: 28193733 PMCID: PMC5358337 DOI: 10.1242/jcs.194308] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 02/02/2017] [Indexed: 01/09/2023] Open
Abstract
The flagellum and flagellum attachment zone (FAZ) are important cytoskeletal structures in trypanosomatids, being required for motility, cell division and cell morphogenesis. Trypanosomatid cytoskeletons contain abundant high molecular mass proteins (HMMPs), but many of their biological functions are still unclear. Here, we report the characterization of the giant FAZ protein, FAZ10, in Trypanosoma brucei, which, using immunoelectron microscopy, we show localizes to the intermembrane staples in the FAZ intracellular domain. Our data show that FAZ10 is a giant cytoskeletal protein essential for normal growth and morphology in both procyclic and bloodstream parasite life cycle stages, with its depletion leading to defects in cell morphogenesis, flagellum attachment, and kinetoplast and nucleus positioning. We show that the flagellum attachment defects are probably brought about by reduced tethering of the proximal domain of the paraflagellar rod to the FAZ filament. Further, FAZ10 depletion also reduces abundance of FAZ flagellum domain protein, ClpGM6. Moreover, ablation of FAZ10 impaired the timing and placement of the cleavage furrow during cytokinesis, resulting in premature or asymmetrical cell division.
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Affiliation(s)
- Bernardo P Moreira
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Carol K Fonseca
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Tansy C Hammarton
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Munira M A Baqui
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
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25
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Sunter JD, Gull K. The Flagellum Attachment Zone: 'The Cellular Ruler' of Trypanosome Morphology. Trends Parasitol 2016; 32:309-324. [PMID: 26776656 PMCID: PMC4827413 DOI: 10.1016/j.pt.2015.12.010] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/27/2015] [Accepted: 12/15/2015] [Indexed: 12/17/2022]
Abstract
A defining feature of Trypanosoma brucei cell shape is the lateral attachment of the flagellum to the cell body, mediated by the flagellum attachment zone (FAZ). The FAZ is a complex cytoskeletal structure that connects the flagellum skeleton through two membranes to the cytoskeleton. The FAZ acts as a ‘cellular ruler’ of morphology by regulating cell length and organelle position and is therefore critical for both cell division and life cycle differentiations. Here we provide an overview of the advances in our understanding of the composition, assembly, and function of the FAZ. The flagellum attachment zone (FAZ) is a large cytoskeletal structure that connects the flagellum skeleton to the cell body cytoskeleton through the membrane of both the flagellum and the cell body. The structure can be divided into eight zones. The FAZ is a key morphogenetic structure regulating both cell length and organelle positioning. Recent studies have identified numerous FAZ proteins. The function of a subset of these proteins has been studied by RNAi, revealing a range of different phenotypes from flagellum detachment to organelle positioning effects. The assembly of the FAZ occurs at its proximal end – the opposite polarity to that of the flagellar axoneme and paraflagellar rod.
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Affiliation(s)
- Jack D Sunter
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK.
| | - Keith Gull
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, UK
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