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Lee H, Huang WH, Sun YC, Lin CT. Investigation of topical amniotic membrane suspension and ReGeneraTing Agent on early corneal stromal healing in rats. Vet Anim Sci 2024; 24:100344. [PMID: 38516389 PMCID: PMC10955657 DOI: 10.1016/j.vas.2024.100344] [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] [Indexed: 03/23/2024] Open
Abstract
Innovative topical bioregenerative materials promoting corneal stromal healing provide valuable alternatives for treating patients with deep corneal ulcers, and particularly beneficial for those with a higher anaesthetic risk. This study aimed to investigate the effects of topical amniotic membrane suspension (AMS) and ReGeneraTing Agent (RGTA) on surgically induced deep stromal ulcers in rats. Eighteen Sprague-Dawley rats were divided into 3 treatment groups: control group (topical normal saline, TID); AMS group (topical AMS, TID); RGTA group (topical RGTA, Q2D). Corneal microsurgery was used to create deep stromal ulcer. Evaluations were performed by corneal opacity grading, spectral domain optical coherence tomography (SD-OCT), histopathology, and immunohistochemistry. One-way ANOVA and Dunnett's test were used for statistical analysis. By the seventh day of treatment, both the AMS and RGTA groups showed significantly greater thickness in corneal stroma (both p-value < 0.05) than the control group. Additionally, the RGTA group exhibited a significantly higher degree of myofibroblast infiltration in the stroma and a greater level of corneal opacity (p < 0.05). No significant differences in the count of inflammatory cells were noted. In conclusion, both AMS and RGTA have demonstrated effectiveness in promoting the early stages of stromal wound healing and wound defect recovery in our research. Both AMS and RGTA have good potential for treating deep corneal ulcers in small animals practice. Further research is necessary to investigate the long-term effects and mechanism of using topical AMS and RGTA on treating deep corneal ulcer in clinical practice.
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Affiliation(s)
- Hao Lee
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University Veterinary Hospital, Taipei, Taiwan
| | - Wei-Hsiang Huang
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Chen Sun
- Department of Ophthalmology, Taipei Tzu Chi General Hospital, New Taipei City, Taiwan
| | - Chung-Tien Lin
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University Veterinary Hospital, Taipei, Taiwan
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Levine ES, Batra NN. Multimodal imaging in a case of presumed secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration. Am J Ophthalmol Case Rep 2024; 34:102040. [PMID: 38532849 PMCID: PMC10963182 DOI: 10.1016/j.ajoc.2024.102040] [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: 11/28/2023] [Revised: 02/21/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose To report the findings supported by multimodal imaging in a case of secondary vitreoretinal lymphoma presenting with inner retina and optic nerve head infiltration. Observations A 64-year-old man with systemic diffuse large B-cell lymphoma presented with reduced visual acuity. Moderate anterior chamber and vitreous cell were present. Fundus exam showed bilateral disc edema and diffuse opaque macular infiltrates with a pseudo cherry-red spot in the left eye. Optical coherence tomography showed inner retinal infiltration and loss of normal architecture. Surgery for tissue biopsy was discussed and declined due to risk. Instead, multimodal imaging and anterior chamber fluid sampling were used as a surrogate for tissue biopsy and helped rule out infectious uveitis and retinal vascular disease. The patient was empirically treated with intravitreal methotrexate with rapid improvement in vision, exam, and quality of life. Conclusions and importance Multimodal imaging can support a presumed diagnosis of secondary vitreoretinal lymphoma in order to proceed with intravitreal methotrexate treatment, which can result in rapid clinical and visual improvement.
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Affiliation(s)
- Emily S. Levine
- Section of Ophthalmology, Department of Surgery, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States
| | - Nikhil N. Batra
- Section of Ophthalmology, Department of Surgery, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States
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Kostolna K, Reiter GS, Frank S, Coulibaly LM, Fuchs P, Röggla V, Gumpinger M, Leitner Barrios GP, Mares V, Bogunovic H, Schmidt-Erfurth U. A Systematic Prospective Comparison of Fluid Volume Evaluation across OCT Devices Used in Clinical Practice. Ophthalmol Sci 2024; 4:100456. [PMID: 38317867 PMCID: PMC10840339 DOI: 10.1016/j.xops.2023.100456] [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] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 02/07/2024]
Abstract
Objective Treatment decisions in neovascular age-related macular degeneration (nAMD) are mainly based on subjective evaluation of OCT. The purpose of this cross-sectional study was to provide a comparison of qualitative and quantitative differences between OCT devices in a systematic manner. Design Prospective, cross-sectional study. Subjects One hundred sixty OCT volumes, 40 eyes of 40 patients with nAMD. Methods Patients from clinical practice were imaged with 4 different OCT devices during one visit: (1) Spectralis Heidelberg; (2) Cirrus; (3) Topcon Maestro2; and (4) Topcon Triton. Intraretinal fluid (IRF), subretinal fluid (SRF), and pigment epithelial detachment (PED) were manually annotated in all cubes by trained human experts to establish fluid measurements based on expert-reader annotations. Intraretinal fluid, SRF, and PED volume were quantified in nanoliters (nL). Bland-Altman plots were created to analyze the agreement of measurements in the central 1 and 6 mm. The Friedman test was performed to test for significant differences in the central 1, 3, and 6 mm. Main Outcome Measures Intraretinal fluid, SRF, and PED volume. Results In the central 6 mm, there was a trend toward higher IRF and PED volumes in Spectralis images compared with the other devices and no differences in SRF volume. In the central 1 mm, the standard deviation of the differences ranged from ± 3 nL to ± 6 nL for IRF, from ± 3 nL to ± 4 nL for SRF, and from ± 7 nL to ± 10 nL for PED in all pairwise comparisons. Manually annotated IRF and SRF volumes showed no significant differences in the central 1 mm. Conclusions Fluid volume quantification achieved excellent reliability in all 3 retinal compartments on images obtained from 4 OCT devices, particularly for clinically relevant IRF and SRF values. Although fluid volume quantification is reliable in all 4 OCT devices, switching OCT devices might lead to deviating fluid volume measurements with higher agreement in the central 1 mm compared with the central 6 mm, with highest agreement for SRF volume in the central 1 mm. Understanding device-dependent differences is essential for expanding the interpretation and implementation of pixel-wise fluid volume measurements in clinical practice and in clinical trials. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Klaudia Kostolna
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Gregor S. Reiter
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Sophie Frank
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | | | - Philipp Fuchs
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Veronika Röggla
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Markus Gumpinger
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | | | - Virginia Mares
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
- Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Hrvoje Bogunovic
- Christian Doppler Laboratory for Artificial Intelligence in Retina, Department of Ophthalmology, Medical University Vienna, Vienna, Austria
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Rauscher FG, Elze T, Francke M, Martinez-Perez ME, Li Y, Wirkner K, Tönjes A, Engel C, Thiery J, Blüher M, Stumvoll M, Kirsten T, Loeffler M, Ebert T, Wang M. Glucose tolerance and insulin resistance/sensitivity associate with retinal layer characteristics: the LIFE-Adult-Study. Diabetologia 2024; 67:928-939. [PMID: 38431705 PMCID: PMC10954961 DOI: 10.1007/s00125-024-06093-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/08/2023] [Indexed: 03/05/2024]
Abstract
AIMS/HYPOTHESIS As the prevalence of insulin resistance and glucose intolerance is increasing throughout the world, diabetes-induced eye diseases are a global health burden. We aim to identify distinct optical bands which are closely related to insulin and glucose metabolism, using non-invasive, high-resolution spectral domain optical coherence tomography (SD-OCT) in a large, population-based dataset. METHODS The LIFE-Adult-Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. Cross-sectional, standardised phenotyping included the assessment of various metabolic risk markers and ocular imaging, such as SD-OCT-derived thicknesses of ten optical bands of the retina. Global and Early Treatment Diabetic Retinopathy Study (ETDRS) subfield-specific optical retinal layer thicknesses were investigated in 7384 healthy eyes of 7384 participants from the LIFE-Adult-Study stratified by normal glucose tolerance, prediabetes (impaired fasting glucose and/or impaired glucose tolerance and/or HbA1c 5.7-6.4% [39-47 mmol/mol]) and diabetes. The association of optical retinal band characteristics with different indices of glucose tolerance (e.g. fasting glucose, area under the glucose curve), insulin resistance (e.g. HOMA2-IR, triglyceride glucose index), or insulin sensitivity (e.g. estimated glucose disposal rate [eGDR], Stumvoll metabolic clearance rate) was determined using multivariable linear regression analyses for the individual markers adjusted for age, sex and refraction. Various sensitivity analyses were performed to validate the observed findings. RESULTS In the study cohort, nine out of ten optical bands of the retina showed significant sex- and glucose tolerance-dependent differences in band thicknesses. Multivariable linear regression analyses revealed a significant, independent, and inverse association between markers of glucose intolerance and insulin resistance (e.g. HOMA2-IR) with the thickness of the optical bands representing the anatomical retinal outer nuclear layer (ONL, standardised β=-0.096; p<0.001 for HOMA2-IR) and myoid zone (MZ; β=-0.096; p<0.001 for HOMA2-IR) of the photoreceptors. Conversely, markers of insulin sensitivity (e.g. eGDR) positively and independently associated with ONL (β=0.090; p<0.001 for eGDR) and MZ (β=0.133; p<0.001 for eGDR) band thicknesses. These global associations were confirmed in ETDRS subfield-specific analyses. Sensitivity analyses further validated our findings when physical activity, neuroanatomical cell/tissue types and ETDRS subfield categories were investigated after stratifying the cohort by glucose homeostasis. CONCLUSIONS/INTERPRETATION An impaired glucose homeostasis associates with a thinning of the optical bands of retinal ONL and photoreceptor MZ. Changes in ONL and MZ thicknesses might predict early metabolic retinal alterations in diabetes.
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Affiliation(s)
- Franziska G Rauscher
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Department of Medical Data Science, University of Leipzig Medical Center, Leipzig, Germany
| | - Tobias Elze
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Schepens Eye Research Institute of Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Mike Francke
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - M Elena Martinez-Perez
- Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Yangjiani Li
- Schepens Eye Research Institute of Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Anke Tönjes
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Christoph Engel
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Joachim Thiery
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Matthias Blüher
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Michael Stumvoll
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Toralf Kirsten
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Department of Medical Data Science, University of Leipzig Medical Center, Leipzig, Germany
| | - Markus Loeffler
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Thomas Ebert
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany.
| | - Mengyu Wang
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Schepens Eye Research Institute of Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Chen R, Zhang S, Peng G, Meng W, Borchert G, Wang W, Yu Z, Liao H, Ge Z, He M, Zhu Z. Deep neural network-estimated age using optical coherence tomography predicts mortality. GeroScience 2024; 46:1703-1711. [PMID: 37733221 PMCID: PMC10828229 DOI: 10.1007/s11357-023-00920-4] [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: 04/04/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
The concept of biological age has emerged as a measurement that reflects physiological and functional decline with ageing. Here we aimed to develop a deep neural network (DNN) model that predicts biological age from optical coherence tomography (OCT). A total of 84,753 high-quality OCT images from 53,159 individuals in the UK Biobank were included, among which 12,631 3D-OCT images from 8,541 participants without any reported medical conditions at baseline were used to develop an age prediction model. For the remaining 44,618 participants, OCT age gap, the difference between the OCT-predicted age and chronological age, was calculated for each participant. Cox regression models assessed the association between OCT age gap and mortality. The DNN model predicted age with a mean absolute error of 3.27 years and showed a strong correlation of 0.85 with chronological age. After a median follow-up of 11.0 years (IQR 10.9-11.1 years), 2,429 deaths (5.44%) were recorded. For each 5-year increase in OCT age gap, there was an 8% increased mortality risk (hazard ratio [HR] = 1.08, CI:1.02-1.13, P = 0.004). Compared with an OCT age gap within ± 4 years, OCT age gap less than minus 4 years was associated with a 16% decreased mortality risk (HR = 0.84, CI: 0.75-0.94, P = 0.002) and OCT age gap more than 4 years showed an 18% increased risk of death incidence (HR = 1.18, CI: 1.02-1.37, P = 0.026). OCT imaging could serve as an ageing biomarker to predict biological age with high accuracy and the OCT age gap, defined as the difference between the OCT-predicted age and chronological age, can be used as a marker of the risk of mortality.
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Affiliation(s)
- Ruiye Chen
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Guankai Peng
- Guangzhou Vision Tech Medical Technology Co., Ltd, GuangZhou, China
| | - Wei Meng
- Guangzhou Vision Tech Medical Technology Co., Ltd, GuangZhou, China
| | - Grace Borchert
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhen Yu
- Central Clinical School, Monash University, Melbourne, Australia
| | - Huan Liao
- Epigenetics and Neural Plasticity Laboratory, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Zongyuan Ge
- Faculty of IT, Monash University, Melbourne, Australia
- Monash Medical AI, Monash University, Melbourne, Australia
| | - Mingguang He
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
| | - Zhuoting Zhu
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
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Zhao J, Wu T, Tan J, Chen Y, Xu X, Guo Y, Jin C, Xiu L, Zhao R, Sun S, Peng C, Li S, Yu H, Liu Y, Wei G, Li L, Wang Y, Hou J, Dai J, Fang C, Yu B. Pancoronary plaque characteristics in STEMI patients with rapid plaque progression: An optical coherence tomography study. Int J Cardiol 2024; 400:131821. [PMID: 38301829 DOI: 10.1016/j.ijcard.2024.131821] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Non-culprit plaque progression is associated with recurrent cardiac ischemic events and worse clinical outcomes. Given that atherosclerosis is a systemic disease, the pancoronary characteristics of patients with rapid plaque progression are unknown. This study aims to identify pancoronary plaque features in patients with ST-segment elevation myocardial infarction (STEMI) with and without rapid plaque progression, focused on the patient level. METHODS AND RESULTS From January 2017 to July 2019, 291 patients underwent 3-vessel optical coherence tomography imaging at the time of the primary procedure and a follow-up angiography interval of 12 months. The final analysis included 237 patients. Overall, 308 non-culprit lesions were found in 78 STEMI patients with rapid plaque progression, and 465 non-culprit plaques were found in 159 STEMI patients without rapid plaque progression. These patients had a higher pancoronary vulnerability (CLIMA-defined high-risk plaque: 47.4% vs. 33.3%; non-culprit plaque rupture: 25.6% vs. 14.5%) and a significantly higher prevalence of other vulnerable plaque characteristics (i.e., lipid-rich plaque, cholesterol crystal, microchannels, calcification, spotty calcification, and thrombus) at baseline versus those without rapid plaque progression. Lesions with rapid progression were highly distributed at the LAD, tending to be near the bifurcation. In multivariate analysis, age ≥ 65 years was an independent predictor of subsequent rapid lesion progression at the patient level, whereas microchannel, spotty calcification, and cholesterol crystal were independent predictors for STEMI patients ≥65 years old. CONCLUSIONS STEMI patients with subsequent rapid plaque progression had higher pancoronary vulnerability and commonly presented vulnerable plaque morphology. Aging was the only predictor of subsequent rapid plaque progression.
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Affiliation(s)
- Jiawei Zhao
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Tianyu Wu
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Jinfeng Tan
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Yuzhu Chen
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Xueming Xu
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Yibo Guo
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Chengmei Jin
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Lili Xiu
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Rui Zhao
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Sibo Sun
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Cong Peng
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Shuang Li
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Huai Yu
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Yanchao Liu
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Guo Wei
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Lulu Li
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Yini Wang
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Jingbo Hou
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Jiannan Dai
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China
| | - Chao Fang
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China.
| | - Bo Yu
- Department of Cardiology, The 2(nd) Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Harbin 150086, China.
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Nissen AHK, Vergmann AS. Clinical Utilisation of Wide-Field Optical Coherence Tomography and Angiography: A Narrative Review. Ophthalmol Ther 2024; 13:903-915. [PMID: 38372953 PMCID: PMC10912399 DOI: 10.1007/s40123-024-00905-2] [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: 01/05/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024] Open
Abstract
Many important abnormalities of the vitreous, retina and choroid are predominantly located in the peripheral retina. In some retinal diseases with both central and peripheral manifestations, pathological structural or vascular changes can be apparent in the periphery before they are detectable in the central retina. Conventional optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) imaging only cover the most posterior 30° of the retina. Wide-field OCT (WF-OCT), though offering detailed cross-sectional imaging of the peripheral retina, is not yet systematically used in clinical practice. This narrative review provides a presentation of the utilisation of WF-OCT and WF-OCT-A in the diagnosis and monitoring of a variety of ophthalmological diseases and discusses the advantages and limitations of the technology. With the rapidly developing technology, multiple WF-OCT and WF-OCT-A devices are now commercially available and enable the clinician to obtain scans within a field of view up to 200°. As detailed in this review, several studies have shown promising results in the application of WF-OCT and WF-OCT-A in diseases of the retina, choroid and vitreous, such as retinal vein occlusion, diabetic retinopathy, ocular oncology, paediatric ophthalmology, uveitis and lesions of the vitreo-retinal interface. In conclusion, WF-OCT and WF-OCT-A can reliably produce high-quality, non-invasive images of the vitreous, retinal, and choroidal structures and vascularity covering the posterior pole as well as the mid and far periphery. These methods can be a valuable part of a multimodal imaging approach in the management of a variety of ocular conditions. Future studies are warranted to investigate the patient outcome benefits of implementation of WF-OCT and WF-OCT-A imaging in a real-life clinical setting.
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Affiliation(s)
- Anne Helene K Nissen
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark
| | - Anna Stage Vergmann
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Kume T, Nishi T, Murasato Y, Koto S, Sasahira Y, Okamoto H, Yamada R, Koyama T, Tamada T, Imai K, Neishi Y, Uemura S. Impact of stent strut link location in proximal balloon edge dilation technique for bifurcation percutaneous coronary intervention. Cardiovasc Interv Ther 2024; 39:137-144. [PMID: 38294663 PMCID: PMC10940397 DOI: 10.1007/s12928-023-00981-4] [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: 08/18/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
The single-stent strategy has generally been accepted as the default approach to bifurcation percutaneous coronary intervention. We have proposed the proximal balloon edge dilation (PBED) technique to prevent stent deformation during side branch (SB) dilation. This bench study aimed to evaluate the impact of stent link location and stent design on stent deformation, obstruction by stent struts at a jailed SB ostium, and incomplete stent apposition in the proximal optimization technique (POT)-PBED procedure. A coronary bifurcation model was used. We intentionally set the absence or presence of stent link on the carina (link-free or link-connect) under videoscope observation and compared stent parameters between 3- and 2-link stents (n = 5 each, n = 20 total). In the link-free group, the SB jailing rate of 3-link stents was significantly higher than that of 2-link stents (15.5 ± 5.1% vs. 6.6 ± 1.2%, p = 0.009). In the link-connect group, the SB jailing rate of 3-link stents was significantly lower than that of 2-link stents (30.0 ± 4.5% vs. 39.0 ± 2.6%, p = 0.009). In the bifurcation segment, the rate of incomplete stent apposition was significantly lower for 3-link stents of the link-connect group than for 2-link stents of the link-connect group (3.3 ± 4.2% vs. 19.0 ± 7.8%, p = 0.009). For both stent designs, ellipticity ratio was higher for link-connect group than link-free group. Link location as well as stent cell design greatly impacted stent deformation during the POT-PBED procedure.
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Affiliation(s)
- Teruyoshi Kume
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan.
| | - Takeshi Nishi
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Yoshinobu Murasato
- Department of Cardiology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Koto
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | | | - Hiroshi Okamoto
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Ryotaro Yamada
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Terumasa Koyama
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Tomoko Tamada
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Koichiro Imai
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Yoji Neishi
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
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9
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Yamada F, Kato K, Nagashima R, Yonekawa Y, Kashima Y, Kondo M. Case of persistent corneal epithelial damage after cataract surgery leading to diagnosis of vitamin A deficiency. Doc Ophthalmol 2024; 148:121-128. [PMID: 38265517 DOI: 10.1007/s10633-023-09963-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE To report our findings of reduced full-field electroretinograms (ff-ERGs) and abnormal optical coherence tomographic (OCT) images in a patient with poor visual acuity after cataract surgery who was eventually diagnosed with vitamin A deficiency (VAD). METHODS This was a clinical study of a patient who complained of blurred vision after cataract surgery. To determine the cause of the reduced vision, we recorded full-field electroretinograms (ff-ERGs) to determine the scotopic and photopic status of the retina. We also performed optical coherence tomography to assess the changes in the retinal structure. Serological tests were performed. RESULTS A 74-year-old man presented with persistent corneal epithelial damages and reduced vision that developed after conventional cataract surgery. OCT showed an interrupted ellipsoid zone, and fundus autofluorescence (FAF) showed a severe hypofluorescence in the retina of the left eye. The scotopic ff-ERGs were severely reduced, and the photopic ff-ERGs were mildly reduced. Serological examinations revealed a vitamin A concentration < 7 IU/dL (normal, 97-316 IU/dL). Based on these findings, we diagnosed the patient with VAD and started treatment with oral vitamin A supplements. After three months, his visual acuity, ff-ERGs, and OCT findings recovered to normal levels. The amplitudes and implicit times of the RETeval flicker ERGs increased to be within the normal range, and the hypofluorescence of the left eye disappeared. The length of the photoreceptor outer segments increased after the vitamin A supplementation. CONCLUSION Our findings indicate that the ERGs are helpful for diagnosing patients with VAD associated with persistent corneal epithelial damages.
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Affiliation(s)
- Fuyuki Yamada
- Department of Ophthalmology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kumiko Kato
- Department of Ophthalmology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Ryunosuke Nagashima
- Department of Ophthalmology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yuka Yonekawa
- Department of Ophthalmology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yuzen Kashima
- Department of Ophthalmology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Mineo Kondo
- Department of Ophthalmology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
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10
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Sung JY, Kim JJ, Hwang JY, Lee MW. Retinal neurodegeneration in diabetic retinopathy with systemic hypertension. Acta Diabetol 2024; 61:495-504. [PMID: 38214740 DOI: 10.1007/s00592-023-02226-5] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE To identify the impact of hypertension (HTN) on inner retinal layer thickness in patients with diabetic retinopathy (DR). METHODS In this retrospective cross-sectional study, participants were divided into three groups: type 2 diabetes patients without DR (DM group), patients with DR (DR group), and patients with both DR and HTN (DR+HTN group). The peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer (GC-IPL) thicknesses, measured using optical coherence tomography, were compared among the groups. RESULTS A total of 470 eyes were enrolled: 224 eyes in the DM group, 131 eyes in the DR group, and 115 eyes in the DR+HTN group. The mean RNFL thicknesses were 95.0 ± 7.7, 92.5 ± 10.1, and 89.2 ± 11.2 μm, and the mean GC-IPL thicknesses were 84.0 ± 5.7, 82.0 ± 7.6, and 79.2 ± 8.1 μm in each group, respectively (all P < 0.001). In the DR+HTN group, the DR stage showed a significant association with pRNFL (B = - 5.38, P = 0.014) and GC-IPL (B = - 5.18, P = 0.001) thicknesses in multivariate analyses. Subgroup analyses revealed that pRNFL (P = 0.007) and GC-IPL (P = 0.005) thicknesses decreased significantly as DR progressed only in the DR+HTN group. CONCLUSIONS Patients with both DR and HTN exhibited much thinner pRNFL and GC-IPL, compared with patients with DR only. These results may have been related to the amplified diabetic retinal neurodegeneration and synergistic impact of ischemia in DR patients with concurrent HTN. Additionally, the progression of DR resulted in more severe inner retinal damage when combined with HTN.
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Affiliation(s)
- Jae-Yun Sung
- Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Jae-Jun Kim
- Department of Ophthalmology, Konyang University Hospital, Konyang University College of Medicine, #1643 Gwanjeo-dong, Seo-gu, Daejeon, Republic of Korea
| | - Jae-Yul Hwang
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Min-Woo Lee
- Department of Ophthalmology, Konyang University Hospital, Konyang University College of Medicine, #1643 Gwanjeo-dong, Seo-gu, Daejeon, Republic of Korea.
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11
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Kimura M, Takeda T, Tsujino Y, Matsumoto Y, Yamaji M, Sakaguchi T, Maeda K, Mabuchi H, Murakami T. Assessing the efficacy of saline flush in frequency-domain optical coherence tomography for intracoronary imaging. Heart Vessels 2024; 39:310-318. [PMID: 38062328 PMCID: PMC10920414 DOI: 10.1007/s00380-023-02340-y] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/08/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND The increased amount of contrast media in frequency-domain optical coherence tomography (FD-OCT) imaging during percutaneous coronary intervention (PCI) has raised potential concerns regarding impairment of renal function. OBJECTIVES This study aimed to evaluate the effectiveness of heparinized saline flush in FD-OCT-guided PCI and identify clinical factors contributing to optimal image quality. METHODS We retrospectively collected 100 lesions from 90 consecutive patients, and a total of 200 pullbacks were analyzed for the initial and final evaluation in which saline was used as the flushing medium. RESULTS The study population had a mean age of 73, with 52% having chronic kidney disease (CKD). The median amount of contrast used was 28 ml, and no complications were observed associated with saline flush OCT. Imaging quality was then categorized as excellent, good, or unacceptable. Among the total runs, 87% demonstrated clinically acceptable image quality, with 66.5% classified as excellent images and 20.5% classified as good images. Independent predictors of excellent images included lumen area stenosis ≥ 70% (adjusted odds ratio [OR] 2.37, 95% confidence interval [CI] 1.02-5.47, P = 0.044), and the use of intensive flushing (adjusted OR 2.06, 95% CI 1.11-3.86, P = 0.023) defined as a deep engagement of guiding catheter (GC) or a selective insertion of guide extension catheter (GE). Intensive flushing was performed in 60% of the total pullbacks, and it was particularly effective in improving image quality in the left coronary artery (LCA). CONCLUSION The use of saline flush during FD-OCT imaging was safe and feasible, which had a benefit in renal protection with adequate imaging quality.
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Affiliation(s)
- Masahiro Kimura
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan.
| | - Teruki Takeda
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Yasushi Tsujino
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Yuichi Matsumoto
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Masayuki Yamaji
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Tomoko Sakaguchi
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Keiko Maeda
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Hiroshi Mabuchi
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Tomoyuki Murakami
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
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Hansen KN, Maehara A, Noori M, Trøan J, Fallesen CO, Hougaard M, Ellert-Gregersen J, Veien KT, Junker A, Hansen HS, Lassen JF, Jensen LO. Optimal lesion preparation before implantation of a Magmaris bioresorbable scaffold in patients with coronary artery stenosis: Rationale, design and methodology of the OPTIMIS study. Contemp Clin Trials Commun 2024; 38:101260. [PMID: 38384894 PMCID: PMC10879808 DOI: 10.1016/j.conctc.2024.101260] [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: 10/11/2023] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Percutaneous coronary intervention with implantation of a bioresorbable scaffold (BRS) provide the vessel support for a limited period allowing the vessel to restore normal vasomotion after degradation of the BRS, opposed to treatment with drug-eluting stents where the metal persist in the vessel wall. Late lumen loss and reduction in lumen area after implantation have been reported. The purpose of this study was to investigate whether intense pre-dilatation before BRS implantation resulted in less reduction of minimal lumen area at 6- and 12-month follow-up after implantation of a Magmaris BRS (MgBRS). Coronary imaging with optical coherence tomography (OCT) and intravascular ultrasound (IVUS) was assessed to track changes in lumen and vessel dimensions. Methods The prospective Optimal lesion PreparaTion before Implantation of the Magmaris bioresorbable scaffold In patients with coronary artery Stenosis (OPTIMIS) study randomly assigned eighty-two patients with chronic coronary syndrome to two pre-dilatation treatment strategies. Patients were randomized in a 1:1 ratio to pre-dilatation with either a non-compliant scoring balloon or a standard non-compliant balloon prior to implantation of a MgBRS. The treated segment was evaluated with OCT and IVUS at baseline, after 6 and 12 months to assess changes in lumen and vessel dimensions. The hypothesis was that more intense pre-dilatation with a non-compliant scoring balloon before MgBRS implantation can reduce the risk of late lumen reduction compared to standard pre-dilatation. The power calculation used expected MLA after 6 months (6.22 mm2 for the scoring balloon and 5.01 mm2 for the standard non-compliant balloon), power of 80 %, significance level of 0.05 and expected drop-out rate of 15 %, requiring 82 patients to be enrolled. Results Eighty-two patients were included in the study. Enrollment was from December 2020 to September 2023. Conclusion The hypothesis was that more intense pre-dilatation with a non-compliant scoring balloon before MgBRS implantation can reduce the risk of late lumen reduction compared to standard pre-dilatation.
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Affiliation(s)
- Kirstine Nørregaard Hansen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Akiko Maehara
- Cardiovascular Research Foundation, New York Presbyterian Hospital, New York, USA
| | - Manijeh Noori
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Jens Trøan
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | - Mikkel Hougaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | | | | | - Anders Junker
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Henrik Steen Hansen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Jens Flensted Lassen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Lisette Okkels Jensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
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Panozzo G, Cicinelli MV, Dalla Mura G, Giannarelli D, Vadalà M, Bonfiglio V, Bellisario G, Bandello F. Enhancing Diabetic Macular Edema Treatment Outcomes: Exploring the ESASO Classification and Structural OCT Biomarkers. Ophthalmol Ther 2024:10.1007/s40123-024-00925-y. [PMID: 38530567 DOI: 10.1007/s40123-024-00925-y] [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: 01/25/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION This study assessed the European School of Advanced Studies in Ophthalmology (ESASO) classification's prognostic value for diabetic macular edema (DME) in predicting intravitreal therapy outcomes. METHODS In this retrospective, multicenter study, patients aged > 50 years with type 1 or 2 diabetes and DME received intravitreal antivascular endothelial growth factor (anti-VEGF) agents (ranibizumab, bevacizumab, and aflibercept) or steroids (dexamethasone). The primary outcome was visual acuity (VA) change post-treatment, termed as functional response, measured 4-6 weeks post-third anti-VEGF or 12-16 weeks post-steroid injection, stratified by initial DME stage. RESULTS Of the 560 eyes studied (62% male, mean age 66.7 years), 31% were classified as stage 1 (early), 50% stage 2 (advanced), 17% stage 3 (severe), and 2% stage 4 (atrophic). Visual acuity (VA; decimal) improved by 0.12-0.15 decimals in stages 1-2 but only 0.03 decimal in stage 3 (all p < 0.0001) and 0.01 in stage 4 (p = 0.38). Even in eyes with low baseline VA ≤ 0.3, improvements were significant only in stages 1 and 2 (0.12 and 0.17 decimals, respectively). Central subfield thickness (CST) improvement was greatest in stage 3 (-229 µm, 37.6%, p < 0.0001), but uncorrelated with VA gains, unlike stages 1 and 2 (respectively: -142 µm, 27.4%; - 5 µm, 12%; both p < 0.0001). Stage 4 showed no significant CST change. Baseline disorganization of retinal inner layers and focal damage of the ellipsoid zone/external limiting membrane did not influence VA improvement in stages 1 and 2. Treatment patterns varied, with 61% receiving anti-VEGF and 39% dexamethasone, influenced by DME stage, with no significant differences between therapeutic agents. CONCLUSION The ESASO classification, which views the retina as a neurovascular unit and integrates multiple biomarkers, surpasses single biomarkers in predicting visual outcomes. Significant functional improvement occurred only in stages 1 and 2, suggesting reversible damage, whereas stages 3 and 4 likely reflect irreversible damage.
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Affiliation(s)
- Giacomo Panozzo
- Ophthalmology Unit, Clinica San Francesco, Verona, Italy.
- ESASO, European School of Advanced Studies in Ophthalmology, Lugano, Switzerland.
| | - Maria V Cicinelli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Dalla Mura
- ESASO, European School of Advanced Studies in Ophthalmology, Lugano, Switzerland
| | - Diana Giannarelli
- UOSD Clinical Trial Center, Biostatistics and Bioinformatics, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Maria Vadalà
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | | - Giovanni Bellisario
- Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Francesco Bandello
- ESASO, European School of Advanced Studies in Ophthalmology, Lugano, Switzerland
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14
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Kang MC, Park KA, Oh SY. Optical coherence tomography and optical coherence tomography angiography findings in optic nerve hypoplasia and their relationships with visual acuity. Sci Rep 2024; 14:7130. [PMID: 38532111 DOI: 10.1038/s41598-024-57118-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
This study aimed to quantitatively assess the thickness of the peripapillary retinal nerve fiber layer (pRNFL) thickness, as well as the microvascular alterations in the macula and peripapillary regions, in optic nerve hypoplasia (ONH) patients compared to normal controls. This was achieved through the utilization of spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA), with a specific focus on elucidating the association between these structural alterations and visual acuity. We included a total of 17 eyes of 12 ONH patients, and 34 eyes of age-matched 34 healthy controls. The pRNFL thickness was quantified using SD-OCT, while OCTA facilitated the visualization and measurement of the microvascular structure images of the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment in the macula and peripapillary area. pRNFL thickness was measured for eight sectors (superior, temporal, inferior, nasal, superotemporal, superonasal, inferotemporal, and inferonasal). SRCP, DRCP, and RPC were measured for four sectors (superior, temporal, inferior, and nasal). Age, gender, and spherical equivalent refractive errors were statistically adjusted for the analysis. Associations of structural parameters with visual acuity in ONH patients were analyzed using Spearman correlation analysis. pRNFL thickness was significantly thinner in ONH patients than in controls for all sectors. Vessel densities of temporal and nasal sectors in DRCP were significantly higher in ONH patients, but vessel densities of the inferior sector in RPC were significantly lower than those in controls. For all sectors, pRNFL thickness was strongly associated with visual acuity in ONH patients. ONH patients showed significant pRNFL thinning and microvascular alterations compared to controls, and pRNFL thickness was strongly associated with visual function. OCT and OCTA are useful tools for evaluating optic disc hypoplasia and its functional status.
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Affiliation(s)
- Min Chae Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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Sun Y, Zhang L, Ye H, Leng L, Chen Y, Su Y, Ren P, Lu H, Peng G. Potential ocular indicators to distinguish posterior cortical atrophy and typical Alzheimer's disease: a cross-section study using optical coherence tomography angiography. Alzheimers Res Ther 2024; 16:64. [PMID: 38528626 DOI: 10.1186/s13195-024-01431-w] [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: 07/07/2023] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Posterior cortical atrophy (PCA) is a form of dementia that frequently displays significant visual dysfunction and relatively preserved cognitive and executive functions, thus hindering early diagnosis and treatment. This study aimed to investigate possible fundus markers in PCA patients and compare them with those of typical Alzheimer's disease (AD) patients to seek potential diagnostic patterns. METHODS Age-matched PCA and AD patients and healthy controls (HC) completed optometry, intraocular pressure measurement, neuropsychologic assessments, optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) examination in one visit. Overall, six outcomes of thicknesses of various retinal layers and seven outcomes of the retinal microvascular network were calculated. After adjusting for age, sex, and years of education, the OCT and OCTA results were analyzed using analysis of covariance and generalized linear models. Correlation analyses were performed using Spearman correlation, and ROC curves were plotted. RESULTS Twelve PCA patients, nineteen AD patients, and thirty HC, aged 45-80 years were included. Fifty HC, thirty AD, and twenty PCA eyes were available for foveal avascular zone (FAZ) area analysis; forty-nine HC, thirty-four AD, and eighteen PCA eyes were available for OCT and OCTA assessments. PCA patients had thinner retinal nerve fiber layer and ganglion cell layer + inner plexiform layer than HC in the 0-3 mm circle and 1-3 mm ring. Few structural differences were observed between the AD group and the other two groups. The flow area of the superficial capillary plexus and the intermediate capillary plexus was smaller in the PCA group than in the HC group in the 0-1 mm circle, 0-3 mm circle. MMSE performed better than any combination of optical parameters in identifying AD and PCA from HC (AUC = 1), while the combination of MoCA, retinal thickness and vascular density of ICP in the 1-3 mm ring, with flow area of ICP in the 0-1 mm circle showed the strongest ability to distinguish PCA from AD (AUC = 0.944). CONCLUSIONS PCA patients exhibited similar impairment patterns to AD patients in the fundus structure and microvascular network. OCTA may aid in the non-invasive detection of AD and PCA, but still remains to be substantiated.
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Affiliation(s)
- Yan Sun
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Lumi Zhang
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Hui Ye
- Department of Ophthalmology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Lumin Leng
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yi Chen
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yujie Su
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Peifang Ren
- Department of Ophthalmology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Hong Lu
- Department of Ophthalmology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
| | - Guoping Peng
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
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Matsuyama T, Fujimura T, Okamura T. Lesion of slit-like stenosis underestimated by fractional flow reserve based on computed tomography images. Int J Cardiovasc Imaging 2024:10.1007/s10554-024-03077-z. [PMID: 38519823 DOI: 10.1007/s10554-024-03077-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] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/02/2024] [Indexed: 03/25/2024]
Abstract
This case report discusses a 74-year-old man presenting with angina pectoris. Coronary computed tomography angiography suggested only mild stenosis in the mid left anterior descending artery (LAD), with fractional flow reserve based on computed tomography images (FFRct) value of 0.87. However, coronary angiography revealed slit-like stenosis in the mid LAD, and the invasive fractional flow reserve (FFR) was measured at 0.72, demonstrating a deviation from the FFRct value.
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Affiliation(s)
- Tetsuya Matsuyama
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Tatsuhiro Fujimura
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Takayuki Okamura
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
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Nishi T, Kume T, Ueno M, Kobayashi Y, Uemura S. Resolution of spontaneous coronary artery dissection involving the left main coronary artery. Cardiovasc Interv Ther 2024:10.1007/s12928-024-00996-5. [PMID: 38520632 DOI: 10.1007/s12928-024-00996-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Takeshi Nishi
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan.
| | - Teruyoshi Kume
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Masahiko Ueno
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
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Kwon HJ, Heo J, Park SH, Park SW, Byon I. Accuracy of generative deep learning model for macular anatomy prediction from optical coherence tomography images in macular hole surgery. Sci Rep 2024; 14:6913. [PMID: 38519532 PMCID: PMC10959933 DOI: 10.1038/s41598-024-57562-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/19/2024] [Indexed: 03/25/2024] Open
Abstract
This study aims to propose a generative deep learning model (GDLM) based on a variational autoencoder that predicts macular optical coherence tomography (OCT) images following full-thickness macular hole (FTMH) surgery and evaluate its clinical accuracy. Preoperative and 6-month postoperative swept-source OCT data were collected from 150 patients with successfully closed FTMH using 6 × 6 mm2 macular volume scan datasets. Randomly selected and augmented 120,000 training and 5000 validation pairs of OCT images were used to train the GDLM. We assessed the accuracy and F1 score of concordance for neurosensory retinal areas, performed Bland-Altman analysis of foveolar height (FH) and mean foveal thickness (MFT), and predicted postoperative external limiting membrane (ELM) and ellipsoid zone (EZ) restoration accuracy between artificial intelligence (AI)-OCT and ground truth (GT)-OCT images. Accuracy and F1 scores were 94.7% and 0.891, respectively. Average FH (228.2 vs. 233.4 μm, P = 0.587) and MFT (271.4 vs. 273.3 μm, P = 0.819) were similar between AI- and GT-OCT images, within 30.0% differences of 95% limits of agreement. ELM and EZ recovery prediction accuracy was 88.0% and 92.0%, respectively. The proposed GDLM accurately predicted macular OCT images following FTMH surgery, aiding patient and surgeon understanding of postoperative macular features.
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Affiliation(s)
- Han Jo Kwon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea
| | - Jun Heo
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea
| | - Su Hwan Park
- Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea
| | - Iksoo Byon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea.
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Elmers J, Colzato LS, Ziemssen F, Ziemssen T, Beste C. Optical coherence tomography as a potential surrogate marker of dopaminergic modulation across the life span. Ageing Res Rev 2024; 96:102280. [PMID: 38518921 DOI: 10.1016/j.arr.2024.102280] [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: 09/27/2023] [Revised: 02/02/2024] [Accepted: 03/18/2024] [Indexed: 03/24/2024]
Abstract
The retina has been considered a "window to the brain" and shares similar innervation by the dopaminergic system with the cortex in terms of an unequal distribution of D1 and D2 receptors. Here, we provide a comprehensive overview that Optical Coherence Tomography (OCT), a non-invasive imaging technique, which provides an "in vivo" representation of the retina, shows promise to be used as a surrogate marker of dopaminergic neuromodulation in cognition. Overall, most evidence supports reduced retinal thickness in individuals with dopaminergic dysregulation (e.g., patients with Parkinson's Disease, non-demented older adults) and with poor cognitive functioning. By using the theoretical framework of metacontrol, we derive hypotheses that retinal thinning associated to decreased dopamine (DA) levels affecting D1 families, might lead to a decrease in the signal-to-noise ratio (SNR) affecting cognitive persistence (depending on D1-modulated DA activity) but not cognitive flexibility (depending on D2-modulated DA activity). We argue that the use of OCT parameters might not only be an insightful for cognitive neuroscience research, but also a potentially effective tool for individualized medicine with a focus on cognition. As our society progressively ages in the forthcoming years and decades, the preservation of cognitive abilities and promoting healthy aging will hold of crucial significance. OCT has the potential to function as a swift, non-invasive, and economical method for promptly recognizing individuals with a heightened vulnerability to cognitive deterioration throughout all stages of life.
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Affiliation(s)
- Julia Elmers
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Lorenza S Colzato
- Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China
| | - Focke Ziemssen
- Ophthalmological Clinic, University Clinic Leipzig, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
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20
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Nelles G, Abdelwahed YS, Seppelt C, Meteva D, Stähli BE, Rai H, Seegers LM, Sieronski L, Musfeldt J, Gerhardt T, Riedel M, Skurk C, Haghikia A, Sinning D, Dreger H, Knebel F, Trippel TD, Krisper M, Klotsche J, Joner M, Landmesser U, Leistner DM. Cholesterol crystals at the culprit lesion in patients with acute coronary syndrome are associated with worse cardiovascular outcomes at two years follow up - results from the translational OPTICO-ACS study program. Int J Cardiol 2024; 399:131665. [PMID: 38141724 DOI: 10.1016/j.ijcard.2023.131665] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/24/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Cholesterol crystals (CCs) represent a feature of advanced atherosclerotic plaque and may be assessed by optical coherence tomography (OCT). Their impact on cardiovascular outcomes in patients presenting with acute coronary syndromes (ACS) is yet unknown. METHODS The culprit lesion (CL) of 346 ACS-patients undergoing preintervention OCT imaging were screened for the presence of CCs and divided into two groups accordingly. The primary end-point was the rate of major adverse cardiac events plus (MACE+) consisting of cardiac death, myocardial infarction, target vessel revascularization and re-hospitalization due to unstable or progressive angina at two years. RESULTS Among 346 patients, 57.2% presented with CCs at the CL. Patients with CCs exhibited a higher prevalence of ruptured fibrous caps (RFC-ACS) (79.8% vs. 56.8%; p < 0.001) and other high-risk features such as thin cap fibroatheroma (80.8% vs. 64.9%; p = 0.001), presence of macrophages (99.0% vs. 85.1%; p < 0.001) as well as a greater maximum lipid arc (294.0° vs. 259.3°; p < 0.001) at the CL as compared to patients without CCs. MACE+ at two years follow-up occurred more often in CC-patients (29.2% vs. 16.1%; p = 0.006) as compared to patients without CCs at the culprit site. Multivariable cox regression analysis identified CCs as independent predictor of MACE+ (HR 1.705; 1.025-2.838 CI, p = 0.040). CONCLUSIONS CCs were associated with conventional high-risk plaque features and associated with increased MACE+-rates at two years follow up. The identification of CCs might be useful as prognostic marker in patients with ACS and assist "precision prevention" in the future.
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Affiliation(s)
- Gregor Nelles
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany.
| | - Youssef S Abdelwahed
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Claudio Seppelt
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Denitsa Meteva
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Barbara E Stähli
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Himanshu Rai
- Department of Cardiology and ISAResearch Center, German Heart Center, 80636 Munich, Germany; Cardiovascular Research Institute (CVRI) Dublin at Mater Private Network Dublin, D07KWR1 Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, D02YN77 Dublin, Ireland
| | - Lena M Seegers
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany
| | - Lara Sieronski
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Johanna Musfeldt
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Teresa Gerhardt
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin; Cardiovascular Research Institute and the Department of Medicine, Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Matthias Riedel
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Carsten Skurk
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Arash Haghikia
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
| | - David Sinning
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany
| | - Henryk Dreger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Fabian Knebel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Tobias D Trippel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Maximillian Krisper
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Augustenburger Platz 1, Germany
| | - Jens Klotsche
- German Rheumatism Research Center Berlin, and Institute for Social Medicine, Epidemiology und Heath Economy, Charité University Medicine Berlin, Campus Charité Mitte, 10117 Berlin
| | - Michael Joner
- Department of Cardiology and ISAResearch Center, German Heart Center, 80636 Munich, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Munich, 80636 Munich, Germany
| | - Ulf Landmesser
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
| | - David M Leistner
- Department of Cardiology, University Clinic Frankfurt, 60590 Frankfurt am Main, Germany; Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, 12203 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; DZHK (German Centre for Cardiovascular Research) partner Site Berlin, 12203 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
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Özen O, Koçak Altıntaş AG. Can objective parameters in optical coherence tomography be useful markers in the treatment and follow-up of type 1 and type 2 macular neovascularizations related to neovascular age-related macular degeneration? Int Ophthalmol 2024; 44:134. [PMID: 38483688 DOI: 10.1007/s10792-024-03073-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE The aim of this study was to compare the responses of type 1 and type 2 macular neovascularizations (MNV) caused by neovascular type age-related macular degeneration (n-AMD) to intravitreal anti-vascular endothelial growth factor (VEGF) treatments using quantitative parameters determined by optical coherence tomography (OCT). Additionally, it was also intended to assess the connections between these quantitative parameters and changes in best-corrected visual acuity (BCVA) and the number of intravitreal anti-VEGF injections required within a year. MATERIALS AND METHODS In our retrospective and observational study, the data of 90 eyes of 90 patients diagnosed with n-AMD and treated with intravitreal anti-VEGF with the "Pro re nata" method were evaluated. Subtypes of existing MNVs were distinguished with previously taken optical coherence tomography angiography (OCTA) images. In spectral domain OCT examinations, central macular thickness (CMT) and central macular volume (CMV) values were recorded at baseline and 12th month. The number of intravitreal anti-VEGF injections during the 12 month follow-up period was also recorded for each patient. Obtained data were compared between MNV types. RESULTS Of the n-AMD cases examined in the study, 56.66% had type 1 MNV and 43.34% had type 2 MNV. The mean baseline BCVA logMAR values in eyes with type 2 MNV (1.15 ± 0.43) were higher than those observed in eyes with type 1 MNV (0.76 ± 0.42) (p = 0.001). Similarly, mean baseline CMT and CMV values in eyes with type 2 MNV were higher than those observed in eyes with type 1 MNV (respectively 424.89 ± 49.46 μm vs. 341.39 ± 37.06 μm; 9.17 ± 0.89 μm3 vs. 8.49 ± 0.53 μm3; p < 0.05). After 12 months of treatment, logMAR values of BCVA (0.86 ± 0.42) in subjects with type 2 MNV were higher than those in subjects with type 1 MNV (0.57 ± 0.37) (p = 0.001). Mean CMT and CMV values at 12th month in subjects with type 2 MNV (379.11 ± 46.36 μm and 8.66 ± 0.79 μm3, respectively) were observed to be higher than those with type 1 MNV (296.95 ± 33.96 μm and 8.01 ± 0.52 mm3, respectively) (p < 0.05). In type 2 MNVs, positive correlations were observed between both baseline and 12th month BCVA logMAR values and baseline CMV (p < 0.05). Similarly, in type 2 MNVs, a positive correlation was observed between 12th month BCVA logMAR values and 12th month CMV (p < 0.05). The total number of intravitreal anti-VEGF injections at 12 months was similar in both groups (p = 0.851). CONCLUSION In this study, in which we performed a subtype analysis of MNV cases, we observed that the visual function was worse at the beginning and the end of the 12th month, and the CMT and CMV values were higher in the type 2 MNV group compared to the type 1 MNV cases. In addition, we found significant correlations between BCVA logMAR values and CMV values in type 2 MNV cases. In the follow-up of these cases, CMT, which is a more widely used quantitative method, and CMV, which is a newer OCT measurement parameter, may be more useful in patient follow-up and evaluation of treatment efficacy, especially for type 2 MNV cases.
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Affiliation(s)
- Osman Özen
- Polatlı Duatepe State Hospital, Ankara, Turkey.
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Deng F, Jia F, Sun Y, Zhang L, Han J, Li D, Yang Q, Hou R, Jiang W. Predictive value of the serum uric acid to high-density lipoprotein cholesterol ratio for culprit plaques in patients with acute coronary syndrome. BMC Cardiovasc Disord 2024; 24:155. [PMID: 38481127 PMCID: PMC10935860 DOI: 10.1186/s12872-024-03824-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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Hyperuricemia and low level of high-density lipoprotein cholesterol (HDL-C) are both risk factors for coronary artery disease (CAD). The uric acid to HDL-C ratio (UHR) has recently been identified as a new inflammatory and metabolic biomarker. However, the relationship between the UHR and coronary culprit plaques has not been fully investigated in patients with acute coronary syndrome (ACS). METHODS A total of 346 patients with ACS were enrolled in this study. Culprit lesion characteristics were assessed by optical coherence tomography (OCT). Logistic regression and linear correlation analyses were performed to assess the association between the UHR and culprit plaques. The predictive value of the UHR was investigated by receiver operating characteristic (ROC) curve analysis. RESULTS The percentages of typical culprit plaques, including ruptures, erosions and thrombi, were greater in the high-UHR subgroup than those in the low-UHR subgroup. A positive relationship was also found between the UHR and diameter stenosis (r = 0.160, P = 0.003) and between the UHR and area stenosis (r = 0.145, P = 0.007). The UHR was found to be independently associated with plaque rupture, erosion and thrombus. Furthermore, ROC analysis suggested that the UHR had a better predictive value than low-density lipoprotein cholesterol. CONCLUSIONS An elevated UHR level was independently related to the occurrence rate of culprit plaques. The UHR is a simple and easily acquired parameter for detecting culprit plaques in patients with ACS.
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Affiliation(s)
- Fuxue Deng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Fang Jia
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Yang Sun
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Lisha Zhang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Jie Han
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Danni Li
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Qiang Yang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Rongrong Hou
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Wei Jiang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
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Dhar D, Ghosh S, Mukherjee S, Dhara S, Chatterjee J, Das S. Assessment of chitosan-coated zinc cobalt ferrite nanoparticle as a multifunctional theranostic platform facilitating pH-sensitive drug delivery and OCT image contrast enhancement. Int J Pharm 2024; 654:123999. [PMID: 38490403 DOI: 10.1016/j.ijpharm.2024.123999] [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: 10/31/2023] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
Colorectal cancer (CC) is one of the most predominant malignancies in the world, with the current treatment regimen consisting of surgery, radiation therapy, and chemotherapy. Chemotherapeutic drugs, such as 5-fluorouracil (5-FU), have gained popularity as first-line antineoplastic agents against CC but have several drawbacks, including variable absorption through the gastrointestinal tract, inconsistent liver metabolism, short half-life, toxicological reactions in several organ systems, and others. Therefore, herein, we develop chitosan-coated zinc-substituted cobalt ferrite nanoparticles (CZCFNPs) for the pH-sensitive (triggered by chitosan degradation within acidic organelles of cells) and sustained delivery of 5-FU in CC cells in vitro. Additionally, the developed nanoplatform served as an excellent exogenous optical coherence tomography (OCT) contrast agent, enabling a significant improvement in the OCT image contrast in a CC tissue phantom model with a biomimetic microvasculature. Further, this study opens up new possibilities for using OCT for the non-invasive monitoring and/or optimization of magnetic targeting capabilities, as well as real-time tracking of magnetic nanoparticle-based therapeutic platforms for biomedical applications. Overall, the current study demonstrates the development of a CZCFNP-based theranostic platform capable of serving as a reliable drug delivery system as well as a superior OCT exogenous contrast agent for tissue imaging.
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Affiliation(s)
- Dhruba Dhar
- School of Medical Sciences and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Subhadip Ghosh
- Department of Nano Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Sayan Mukherjee
- School of Medical Sciences and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Santanu Dhara
- School of Medical Sciences and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Jyotirmoy Chatterjee
- School of Medical Sciences and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Soumen Das
- School of Medical Sciences and Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India.
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Kobayashi N, Shibata Y, Kurihara O, Todoroki T, Tsutsumi M, Shirakabe A, Shigihara S, Sawatani T, Kiuchi K, Takano M, Asai K. Clinical Background and Coronary Artery Lesions Characteristics in Japanese Patients With Acute Coronary Syndrome Suffering Major Bleeding. Circ Rep 2024; 6:64-73. [PMID: 38464989 PMCID: PMC10920023 DOI: 10.1253/circrep.cr-24-0003] [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: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 03/12/2024] Open
Abstract
Background: Although the clinical factors that predict major bleeding in Western patients with acute coronary syndrome (ACS) are becoming elucidated, they have not been fully investigated, especially coronary lesion characteristics, in a Japanese population. Methods and Results: ACS patients (n=1,840) were divided into a "bleeding group" and a "no-bleeding group," according to whether they had major bleeding during the 2-year follow-up period, to investigate the prognostic effect of bleeding and the predictive factors of bleeding. Among them, patients who underwent primary percutaneous coronary intervention with optical coherence tomography (OCT) guidance (n=958) were examined to identify the effect of coronary lesion characteristics on bleeding. Of the 1,840 enrolled patients, 124 (6.7%) experienced major bleeding during the 2-year follow-up period. Incidence of cardiovascular death during the 2-year follow-up period was significantly higher among patients with major bleeding (26.4% vs. 8.5%, P=0.001). OCT examination showed that disrupted fibrous cap (DFC: 68% vs. 48%, P=0.014) and calcified plaque (63% vs. 42%, P=0.011) were more prevalent in the bleeding group. DFC was a predictor of major bleeding in the multivariate Cox proportional hazards analyses (hazard ratio 2.135 [95% confidence interval 1.070-4.263], P<0.001). Conclusions: ACS patients with major bleeding had poorer cardiac outcomes. Advanced atherosclerosis at the culprit lesion influences the higher incidence of major bleeding in ACS patients.
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Affiliation(s)
- Nobuaki Kobayashi
- Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Yusaku Shibata
- Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Osamu Kurihara
- Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Takahiro Todoroki
- Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Masayuki Tsutsumi
- Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Akihiro Shirakabe
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Shota Shigihara
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Tomofumi Sawatani
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Kazutaka Kiuchi
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Masamichi Takano
- Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital Inzai Japan
| | - Kuniya Asai
- Department of Cardiovascular Medicine, Nippon Medical School Tokyo Japan
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da Silva FDBB, Silva LCP, Cunha LP, Zacharias LC, Navajas EV, Monteiro MLR, Preti RC. Relationship between automated choroidal thickness measurements and retinal sensitivity using microperimetry in patients with myopia and different stages of myopic maculopathy. Int J Retina Vitreous 2024; 10:26. [PMID: 38454499 PMCID: PMC10921787 DOI: 10.1186/s40942-024-00541-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
PURPOSE To assess the relationship between macular choroidal thickness (CT) measurements and retinal sensitivity (RS) in eyes with myopia and different stages of myopic maculopathy. METHODS A masked, cross-sectional, and consecutive study involving patients with emmetropia/myopia (control group) and high myopia (HM) eyes. Automated choroidal thickness (CT) and manual outer retinal layer (ORL) thickness were acquired using swept-source optical coherence tomography, while retinal sensitivity (RS) assessed by microperimetry (MP3) in all regions of the macular Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Comparisons were made between groups, and correlations were performed among these measurements, demographic and ocular parameters and myopic maculopathy classification. RESULTS A total of 37 (74 eyes) patients were included in the study. The mean age was 39 ± 13 years, and 28 patients (76%) were female. HM eyes exhibited inferior best-corrected visual acuity and a more advanced myopic maculopathy classification compared to the control group. The mean macular CT were 255 and 179 μm in the control and HM eyes (P < 0.001), respectively. In the HM eyes, superior ETDRS region presented the greatest values. Mean RS in control and HM groups was 28 and 24 dB (P = 0.001), respectively. Inner temporal followed by superior, were the regions of higher RS. Mean ORL thickness was 83 and 79 μm (P < 0.001), in the control and HM groups, respectively. The inner temporal ETDRS region presented the thickest measure. CT correlated significantly with RS (r = 0.41, P < 0.001) and ORL thickness, (r = 0.58, P < 0.001), which also correlated with RS (r = 0.40, P < 0.001). Spherical equivalent, axial length and myopic maculopathy stage were the parameters that most correlated with CT, RS and ORL thickness. For every 100 μm increase in thickening of CT there was an average increase of 3.4 μm in ORL thickness and 2.7 dB in RS. Myopic maculopathy classification demonstrated influence only with CT. CONCLUSION Myopia degree is related to ORL and choroidal thinning and deterioration of retinal sensitivity in some ETDRS regions of the macula. Choroidal thinning is associated to with a decline of retinal sensitivity, thinning of ORL, and worsening of myopic maculopathy classification, so new treatments are necessary to prevent myopia progression.
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Affiliation(s)
| | | | - Leonardo Provetti Cunha
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
- Division of Ophthalmology, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | | | - Eduardo V Navajas
- Division of Ophthalmology, University of British Columbia, Vancouver, Canada
| | - Mario L R Monteiro
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Rony C Preti
- Division of Ophthalmology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
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Mrabet S, Falfoul Y, Bouassida M, Souissi A, El Matri K, Gharbi A, Chebil A, Kacem I, El Matri L, Gouider R. Retinal changes in multiple sclerosis: An optical coherence tomography and angiography study. Rev Neurol (Paris) 2024:S0035-3787(24)00421-1. [PMID: 38458836 DOI: 10.1016/j.neurol.2023.11.014] [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: 06/29/2023] [Revised: 10/28/2023] [Accepted: 11/07/2023] [Indexed: 03/10/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system with neuroaxonal damage. It is the principal driver of non-traumatic disability in young adults. Visual symptoms are common and optic neuritis (ON) may be the revealing feature in up to 30% of cases. Structural optical coherence tomography (OCT) represents a biomarker of central nervous system neurodegeneration in MS. OCT-angiography (OCT-A) is a noninvasive tool allowing the study of retinal vasculature and the detection of microvascular damage in neuro-retinal diseases. In this study, we aimed to assess structural and microvascular retinal changes in patients with MS with and without ON and to correlate the findings with visual function and MS disability. METHODS We conducted a cross-sectional study including patients diagnosed with MS according to the 2017 McDonald criteria. All patients underwent complete neurological examination with evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score (MSSS) and an ophthalmological examination including OCT and OCT-A. Patients were compared with age- and sex-matched healthy subjects. The primary endpoints were assessment of retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL+), and ganglion cell complex (GCL++) thicknesses on OCT. Vascular densities in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) were assessed on OCT-A, as well as central avascular zone (CAZ) parameters, lacunarity and fractal dimension. RESULTS A total of 160 MS eyes with and without a previous history of ON and 64 age- and gender-matched healthy eyes were analyzed. Among 160 eyes with MS, 69 had a history of ON. We observed a decrease in RNFL and GCL++ thickness in all 12 quadrants in MS patients when compared to healthy controls. Multivariate analysis by linear regression noted a significant correlation for temporal GCL++ and inferonasal RNFL thickness that were decreased in the MS group. A greater decrease in retinal layers thickness was identified in MS patients with a history of ON. On OCT-A, vascular density in (SCP) was significantly reduced in the MS group (P<0.002). A significant correlation between RNFL thickness and retinal vascular density was found but only in less than half of the hourly quadrants. A significant correlation was noted between visual acuity and CC density (P<0.0001). We also noted an inverse correlation between EDSS scores and CC density (P=0.02 and r=-0.275) and between MSSS and RNFL/GCL++ thicknesses. CONCLUSIONS RNFL and GCL++ layers were thinner in MS patients with a history of ON and were reversely correlated with disease severity. Moreover, retinal vascular changes were observed in MS even in eyes without ON, and CC was reversely correlated with visual function and current disability. Thus, structural OCT coupled with OCT-A could represent a noninvasive and dynamic biomarker of MS severity and progression.
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Affiliation(s)
- S Mrabet
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, 2010 Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - Y Falfoul
- Department B, Hedi Raies Institute of Ophthalmology, Oculogenetic Laboratory LR14SP01, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - M Bouassida
- Department B, Hedi Raies Institute of Ophthalmology, Oculogenetic Laboratory LR14SP01, Tunis, Tunisia
| | - A Souissi
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, 2010 Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - K El Matri
- Department B, Hedi Raies Institute of Ophthalmology, Oculogenetic Laboratory LR14SP01, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - A Gharbi
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, 2010 Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - A Chebil
- Department B, Hedi Raies Institute of Ophthalmology, Oculogenetic Laboratory LR14SP01, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - I Kacem
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, 2010 Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - L El Matri
- Department B, Hedi Raies Institute of Ophthalmology, Oculogenetic Laboratory LR14SP01, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - R Gouider
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health LR 18SP03, Razi University Hospital - Manouba, 2010 Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia.
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Elborae A, Hassan M, Meguid MA, Bakry K, Samir A, Brilakis E, Kandil H, ElGuindy A. Self-Apposing Stents in Coronary Chronic Total Occlusions: A Pilot Study. Heart Lung Circ 2024:S1443-9506(24)00044-1. [PMID: 38448254 DOI: 10.1016/j.hlc.2024.01.014] [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: 05/31/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES This pilot study assessed the 12-month angiographic and clinical outcomes of self-apposing (SA) stents in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND Self-apposing (SA) stents may decrease incomplete strut apposition and stent strut coverage that are common after CTO PCI. METHODS We compared 20 patients who underwent CTO PCI using SA drug-eluting stents (DESs) with 20 matched control patients who underwent CTO PCI using balloon-expandable (BE)-DESs. All patients were followed up clinically for 12 months and had coronary angiography with optical coherence tomography at the end of the follow-up period. The primary end points were stent strut malapposition and strut coverage. The secondary end point was composite major adverse cardiovascular events (MACEs) at 12 months. RESULTS Both groups had high prevalence of diabetes mellitus, and most of the treated lesions were complex, with 62% having a J-CTO score of ≥3. All CTO PCI techniques were allowed for recanalisation, and 75% of the procedures were guided by intravascular ultrasound. At 12 months, the SA-DES group had fewer malapposed struts (0% [interquartile range (IQR) 0%-0%] vs 4.5% [IQR 0%-20%]; p<0.001) and uncovered struts (0.08% [IQR 0%-1.6%] vs 8.2% [IQR 0%-16%]; p<0.001). However, they showed significantly higher rates of MACEs due to clinically-driven target lesion revascularisation (45% vs 15%; p=0.038). CONCLUSIONS In this pilot study, compared with conventional BE-DESs, SA-DESs used in CTO PCI were associated with fewer malapposed and uncovered stent struts but also with significantly higher rates of in-stent restenosis and MACEs, mainly caused by clinically driven target lesion revascularisation.
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Affiliation(s)
- Ahmed Elborae
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt.
| | - Mohamed Hassan
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohammed Abdel Meguid
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Karim Bakry
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
| | - Ahmad Samir
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
| | | | - Hossam Kandil
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed ElGuindy
- Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
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Garbrecht JL, Powell ZR, McClard CK, Noori J. Frosted branch angiitis in a patient with systemic juvenile idiopathic arthritis: a case report. BMC Ophthalmol 2024; 24:106. [PMID: 38443873 PMCID: PMC10916308 DOI: 10.1186/s12886-024-03373-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Frosted branch angiitis is a retinal vascular condition that is associated with a viral infection or autoimmune disorders like Crohn's disease, systemic lupus erythematosus, and Behcet's disease. Frosted branch angiitis presents with vascular inflammation, retinal edema, and severe retinal vascular sheathing. We present a case of systemic juvenile idiopathic arthritis, an autoinflammatory disease, presenting with frosted branch angiitis. REPORT OF CASE A 14-year-old female with systemic juvenile idiopathic arthritis and a history of bilateral anterior uveitis developed acute unilateral vision loss and was found to have frosted branch angiitis complicated by branch retinal vein occlusion. She underwent an extensive serology workup and aqueous viral PCR to rule out other possible autoimmune and viral etiologies for forested branch angiitis. She received systemic and intravitreal antiviral treatment due to positive CMV IgM initially. However, the clinical picture improved following the use of a higher dose of oral steroids and the switch of the immunosuppressive agent to a TNF-a inhibitor. CONCLUSION To our knowledge, this would be the first case in the literature demonstrating a systemic juvenile idiopathic arthritis patient presenting with frosted branch angiitis. Infectious causes still must be ruled out, especially CMV, as it is the most common cause of secondary frosted branch angiitis.
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Affiliation(s)
| | - Zachary R Powell
- University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Cynthia K McClard
- University of Oklahoma College of Medicine, Oklahoma City, OK, USA
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, 608 Stanton L Young Blvd, 73104, Oklahoma City, OK, USA
| | - Jila Noori
- University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, 608 Stanton L Young Blvd, 73104, Oklahoma City, OK, USA.
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Schoovaerts M, Ourak M, Borghesan G, Putzeys T, Poorten EV, Verhaert N. OCT-based intra-cochlear imaging and 3D reconstruction: ex vivo validation of a robotic platform. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03081-7. [PMID: 38436923 DOI: 10.1007/s11548-024-03081-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE The small size of the cochlea, and its location deeply embedded in thick temporal bone, poses a challenge for intra-cochlear guidance and diagnostics. Current radiological imaging techniques are not able to visualize the cochlear microstructures in detail. Rotational optical coherence tomography (OCT) fibers show great potential for intra-cochlear guidance. The generated images could be used to map, and study, the tiny cochlear microstructures relevant for hearing. METHODS This work describes the design of a rotational OCT probe with an outer diameter of 0.9 mm. It further discusses a robotic system, which features a remote center of motion mechanism, dedicated to the probe's positioning, fine manipulation and stable insertion into the cochlear micro-spaces. Furthermore, the necessary calibration steps for 3D reconstruction are described, followed by a detailed quantitative analysis, comparing the 3D reconstructions using a synthetic, 2:1 scaled scala tympani model with a reconstruction from micro-CT, serving as the ground truth. Finally, the potential of the system is demonstrated by scanning a single ex vivo cadaveric human cochlea. RESULTS The study investigates five insertions in the same 2:1 scaled tympani model, along with their corresponding 3D reconstruction. The comparison with micro-CT results in an average root-mean-square error of 74.2 µm, a signed distance error of 38.1 µm and a standard deviation of 63.6 µm. The average F-score of the reconstructions, using a distance threshold of 100 and 74.2 µm, resulted in 83.0% and 71.8%, respectively. Insertion in the cadaveric human cochlea showed the challenges for straight insertion, i.e., navigating the hook region. CONCLUSION Overall, the system shows great potential for intra-cochlear guidance and diagnostics, due to the system's capability for precise and stable insertion into the basal turn in the scala tympani. The system, combined with the calibration procedure, results in detailed and precise 3D reconstructions.
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Affiliation(s)
- Maarten Schoovaerts
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium.
- Department of Neurosciences, KU Leuven, Herestraat 49, 3001, Leuven, Belgium.
| | - Mouloud Ourak
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium
| | - Gianni Borghesan
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium
- Flanders Make, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium
| | - Tristan Putzeys
- Department of Neurosciences, KU Leuven, Herestraat 49, 3001, Leuven, Belgium
- Department of Physics and Astronomy, KU Leuven, Celestijnenlaan 200, 3001, Leuven, Belgium
| | | | - Nicolas Verhaert
- Department of Neurosciences, KU Leuven, Herestraat 49, 3001, Leuven, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Leuven, Herestraat 49, 3001, Leuven, Belgium
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De Arrigunaga S, Wall S, Theotoka D, Friehmann A, Camacho M, Dubovy S, Galor A, Karp CL. Chronic inflammation as a proposed risk factor for ocular surface squamous neoplasia. Ocul Surf 2024:S1542-0124(24)00028-4. [PMID: 38432640 DOI: 10.1016/j.jtos.2024.02.006] [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: 04/26/2023] [Revised: 12/19/2023] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Chronic inflammation is a predisposing factor for metaplastic changes and ultimately dysplasia. We describe cases of OSSN occurring in the setting of chronic ocular surface inflammation. METHODS Sixteen eyes from 14 individuals were included from one ocular oncology clinic between 2010 and 2023. Patients presented with ocular surface squamous neoplasia (OSSN) in the setting of chronic inflammation. The diagnosis of OSSN was made using anterior segment high-resolution optical coherence tomography (HR-OCT) and confirmed by histopathological analysis in all cases. RESULTS Median age on presentation was 61 [IQR 47.5-69.2] years. Eleven (86%) individuals were male and five (36%) identified as White Hispanic. Ten eyes were referred with ocular surface diagnoses including pannus (n = 4), scarring (n = 3), pterygium (n = 2), and herpetic keratitis (n = 1). Only six eyes were referred as possible neoplasia. All individuals had a history of ocular surface inflammation. The most common inflammatory conditions were ocular rosacea (seven individuals) and atopic keratoconjunctivitis (AKC) (five individuals). Two individuals were found to have bilateral OSSN, one in the setting of ocular rosacea and the other in the setting of AKC. All 16 eyes from 14 individuals were suspected to have OSSN based on HR-OCT findings which guided the location of the incisional biopsies that subsequently confirmed histopathological diagnosis in all cases. CONCLUSION OSSN may arise in the setting of chronic inflammation on the ocular surface. Identification of the tumor can be challenging in these cases, and HR-OCT can be a key diagnostic tool in detecting OSSN.
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Affiliation(s)
- Sofia De Arrigunaga
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA
| | - Sarah Wall
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA; Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Despoina Theotoka
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA; Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Asaf Friehmann
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA; Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; Sackler faculty of Medicine, Tel Aviv University, Israel
| | - Matthew Camacho
- Florida Lions Ocular Pathology Laboratory, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sander Dubovy
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA; Florida Lions Ocular Pathology Laboratory, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anat Galor
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA; Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Carol L Karp
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA
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Yousefi S, Huang X, Poursoroush A, Majoor J, Lemij H, Vermeer K, Elze T, Wang M, Nouri-Mahdavi K, Mohammadzadeh V, Brusini P, Johnson C. An Artificial Intelligence Enabled System for Retinal Nerve Fiber Layer Thickness Damage Severity Staging. Ophthalmol Sci 2024; 4:100389. [PMID: 37868793 PMCID: PMC10585627 DOI: 10.1016/j.xops.2023.100389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 10/24/2023]
Abstract
Purpose To develop an objective glaucoma damage severity classification system based on OCT-derived retinal nerve fiber layer (RNFL) thickness measurements. Design Algorithm development for RNFL damage severity classification based on multicenter OCT data. Subjects and Participants A total of 6561 circumpapillary RNFL profiles from 2269 eyes of 1171 subjects to develop models, and 2505 RNFL profiles from 1099 eyes of 900 subjects to validate models. Methods We developed an unsupervised k-means model to identify clusters of eyes with similar RNFL thickness profiles. We annotated the clusters based on their respective global RNFL thickness. We computed the optimal global RNFL thickness thresholds that discriminated different severity levels based on Bayes' minimum error principle. We validated the proposed pipeline based on an independent validation dataset with 2505 RNFL profiles from 1099 eyes of 900 subjects. Main Outcome Measures Accuracy, area under the receiver operating characteristic curve, and confusion matrix. Results The k-means clustering discovered 4 clusters with 1382, 1613, 1727, and 1839 samples with mean (standard deviation) global RNFL thickness of 58.3 (8.9) μm, 78.9 (6.7) μm, 87.7 (8.2) μm, and 101.5 (7.9) μm. The Bayes' minimum error classifier identified optimal global RNFL values of > 95 μ m , 86 to 95 μ m , 70 to 85 μ m , and < 70 μ m for discriminating normal eyes and eyes at the early, moderate, and advanced stages of RNFL thickness loss, respectively. About 4% of normal eyes and 98% of eyes with advanced RNFL loss had either global, or ≥ 1 quadrant, RNFL thickness outside of normal limits provided by the OCT instrument. Conclusions Unsupervised machine learning discovered that the optimal RNFL thresholds for separating normal eyes and eyes with early, moderate, and advanced RNFL loss were 95 μ m , 85 μm, and 70 μ m , respectively. This RNFL loss classification system is unbiased as there was no preassumption or human expert intervention in the development process. Additionally, it is objective, easy to use, and consistent, which may augment glaucoma research and day-to-day clinical practice. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Siamak Yousefi
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee
- Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Xiaoqin Huang
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Asma Poursoroush
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Julek Majoor
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Hans Lemij
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Koen Vermeer
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachussetts
| | - Mengyu Wang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachussetts
| | - Kouros Nouri-Mahdavi
- Department of Ophthalmology, University of California Los Angeles, Los Angeles, California
| | - Vahid Mohammadzadeh
- Department of Ophthalmology, University of California Los Angeles, Los Angeles, California
| | - Paolo Brusini
- Department of Ophthalmology, “Città di Udine” Health Center, Udine, Italy
| | - Chris Johnson
- Department of Ophthalmology & Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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KhalafAllah MT, Fuchs PA, Nugen F, El Hamdaoui M, Levy AM, Samuels BC, Grytz R. Heterogenous thinning of peripapillary tissues occurs early during high myopia development in juvenile tree shrews. Exp Eye Res 2024; 240:109824. [PMID: 38336167 DOI: 10.1016/j.exer.2024.109824] [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: 11/15/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
Myopia is an independent risk factor for glaucoma, but the link between both conditions remains unknown. Both conditions induce connective tissue remodeling at the optic nerve head (ONH), including the peripapillary tissues. The purpose of this study was to investigate the thickness changes of the peripapillary tissues during experimental high myopia development in juvenile tree shrews. Six juvenile tree shrews experienced binocular normal vision, while nine received monocular -10D lens treatment starting at 24 days of visual experience (DVE) to induce high myopia in one eye and the other eye served as control. Daily refractive and biometric measurements and weekly optical coherence tomography scans of the ONH were obtained for five weeks. Peripapillary sclera (Scl), choroid-retinal pigment epithelium complex (Ch-RPE), retinal nerve fiber layer (RNFL), and remaining retinal layers (RRL) were auto-segmented using a deep learning algorithm after nonlinear distortion correction. Peripapillary thickness values were quantified from 3D reconstructed segmentations. All lens-treated eyes developed high myopia (-9.8 ± 1.5 D), significantly different (P < 0.001) from normal (0.69 ± 0.45 D) and control eyes (0.76 ± 1.44 D). Myopic eyes showed significant thinning of all peripapillary tissues compared to both, normal and control eyes (P < 0.001). At the experimental end point, the relative thinning from baseline was heterogeneous across tissues and significantly more pronounced in the Scl (-8.95 ± 3.1%) and Ch-RPE (-16.8 ± 5.8%) when compared to the RNFL (-5.5 ± 1.6%) and RRL (-6.7 ± 1.8%). Furthermore, while axial length increased significantly throughout the five weeks of lens wear, significant peripapillary tissue thinning occurred only during the first week of the experiment (until a refraction of -2.5 ± 1.9 D was reached) and ceased thereafter. A sectorial analysis revealed no clear pattern. In conclusion, our data show that in juvenile tree shrews, experimental high myopia induces significant and heterogeneous thinning of the peripapillary tissues, where the retina seems to be protected from profound thickness changes as seen in Ch-RPE and Scl. Peripapillary tissue thinning occurs early during high myopia development despite continued progression of axial elongation. The observed heterogeneous thinning may contribute to the increased risk for pathological optic nerve head remodeling and glaucoma later in life.
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Affiliation(s)
- Mahmoud T KhalafAllah
- Vision Science Graduate Program, The University of Alabama at Birmingham, Birmingham, AL, United States; Department of Ophthalmology, Menoufia University, Shebin Elkom, Menoufia, Egypt
| | - Preston A Fuchs
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Fred Nugen
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mustapha El Hamdaoui
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Alexander M Levy
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Brian C Samuels
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rafael Grytz
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States.
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Wang DJ, Mendel TA. A unique presentation of subretinal fluid in a type III torpedo maculopathy phenotype. Am J Ophthalmol Case Rep 2024; 33:101971. [PMID: 38131064 PMCID: PMC10733669 DOI: 10.1016/j.ajoc.2023.101971] [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: 05/06/2023] [Revised: 10/28/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose To report a rare type III torpedo maculopathy lesion with a unique manifestation of subretinal fluid. Observations A nine-year-old patient was referred to retina for an evaluation of a hypopigmented oval-shaped lesion in the temporal macula with an area of inferior subretinal fluid in the right eye. The lesion demonstrated inner and outer retinal and retinal pigment epithelial attenuation, intraretinal and subretinal fluid, a serous neurosensory retinal detachment, and inner choroidal excavation on optical coherence tomography. Fundus autofluorescence showed a lane of downward-tracking fluid. Intravenously administered fluorescein angiography revealed a window defect in the area of the torpedo lesion suggesting choroidal flush. Conclusions and Importance The case is the third documented case of torpedo maculopathy with subretinal fluid in the literature with a unique combination of intraretinal cystic changes and dependent descending subretinal fluid, somewhat akin to a Best disease outside of the fovea with choroidal excavation. The morphology of torpedo maculopathy continues to expand as more cases are revealed.
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Affiliation(s)
- Derrick J. Wang
- Havener Eye Institute, Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Thomas A. Mendel
- Havener Eye Institute, Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Kanclerz P, Bazylczyk N. Illumination levels in commonly used ophthalmic devices. Graefes Arch Clin Exp Ophthalmol 2024; 262:995-996. [PMID: 37548670 PMCID: PMC10907405 DOI: 10.1007/s00417-023-06189-9] [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: 05/30/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023] Open
Abstract
Pupil diameter is a key parameter for corneal and multifocal intraocular lens surgery. Many devices are dedicated to measure the pupil size, but do not specify the illumination during capture. The aim of this study was to present illumination levels in routinely used ophthalmic devices which present pupil sizes. To obtain measurements, the lux meter was placed in the chin rest in the corneal plane and the room was completely dimmed. Ten measurements were taken for each device. The illumination levels for white and red Placido disk corneal topographers were 1253.1 ± 0.2 and 329.0 ± 0.2 lux, respectively (both photopic conditions). Scheimpflug corneal tomography should be considered as a mesopic measurement (14.5 ± 0.1 lux). Optical coherence tomography and autorefractometry are scotopic measurements (0.4-0.6 lux). We postulate that producers should provide illumination levels of their devices measuring pupil size. Moreover, when mentioning a pupil size, one should consider presenting to what lighting conditions it refers to.
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Affiliation(s)
- Piotr Kanclerz
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.
- Department of Ophthalmology, Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286, Gdańsk, Poland.
| | - Natasza Bazylczyk
- Department of Ophthalmology, Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286, Gdańsk, Poland
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Naftali S, Della Rocca K, Gershoni A, Ehrlich R, Ratnovsky A. Mechanical impact of epiretinal membranes on the retina utilizing finite element analysis. Comput Methods Programs Biomed 2024; 245:108020. [PMID: 38237448 DOI: 10.1016/j.cmpb.2024.108020] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/14/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND AND OBJECTIVE Epiretinal membrane (ERM) is a transparent membrane that forms on the surface of the neurosensory retina, causing tangential traction on the retinal surface, which may contribute to cell proliferation and contraction. Epiretinal membranes (ERMs) may be asymptomatic in some patients, while in others the membranes can progress, resulting in macular thickening and macular traction, thus distorting and inducing loss of central visual function and metamorphopsia. Currently, treatment options include follow-up or pars plana vitrectomy with an ERM peel, aiming to relieve the macular traction and improve vision and metamorphopsia. No specific criteria exist for predicting which patients might progress and need early surgery to improve and maintain good vision. The decision for surgery is based on the individual's symptoms and the physician's judgment. This study aimed to evaluate the mechanical impact in terms of stress and deformations of the ERM and to qualitatively compare them with the clinical progression of fovea thickening observed through optical coherence tomography (OCT) images. METHODS Numerical simulation on a three-dimensional geometrical retina and ERM model was applied to isolate factors that can be used to predict its progression and prognosis. OCT images of 14 patients with ERM were used to derive the fovea thickness progression before and after vitrectomy surgery with ERM peeling. RESULTS The results clearly show that the increase in ERM contractility level increases the developed stress at the fovea, which spreads and advances toward its base. The highest stress level (2.1 kPa) was developed at the highest and asymmetric contractility, producing non-uniform distributed deformations that distort the fovea structure. CONCLUSIONS These findings imply that high and asymmetric ERM contractility should be evaluated clinically as a factor that might signal the need for early vitrectomy surgery to avoid irreversible visual loss. Moreover, the OCT images revealed that in some cases, the thickness of the fovea indeed remains high, even after ∼12 months postoperatively, which also indicates that the deformation of the fovea in these cases is irreversible.
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Affiliation(s)
- Sara Naftali
- School of Medical Engineering, Afeka Tel Aviv Academic College of Engineering, Tel Aviv, 6998812, Israel.
| | - Keren Della Rocca
- School of Medical Engineering, Afeka Tel Aviv Academic College of Engineering, Tel Aviv, 6998812, Israel
| | - Assaf Gershoni
- Ophthalmology Division, Rabin Medical Center, Petach Tikva, Israel; Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Rita Ehrlich
- Ophthalmology Division, Rabin Medical Center, Petach Tikva, Israel; Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Anat Ratnovsky
- School of Medical Engineering, Afeka Tel Aviv Academic College of Engineering, Tel Aviv, 6998812, Israel
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He Q, Fan Y, Xu Z, Zhang J. Evaluation of post-dilatation on longitudinal stent deformation and postprocedural stent malapposition in the left main artery by optical coherence tomography (OCT): an in vitro study. BMC Med Imaging 2024; 24:53. [PMID: 38429683 PMCID: PMC10908124 DOI: 10.1186/s12880-024-01223-6] [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: 02/17/2023] [Accepted: 02/05/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND The diameter of the ostial and proximal left main coronary artery can be greater than 5.0 mm. However, the diameters of the mostly available coronary drug-eluting stents (DESs) are ≤ 4.0 mm. Whether high-pressure dilatation can increase the diameter of stents from 4.0 to 5.0 mm and whether post-dilatation leads to longitudinal stent deformation (LSD) of 4.0-mm-diameter stents have rarely been studied. Therefore, this study aims to evaluate LSD and stent malapposition of six types of commercially available 4.0-mm-diameter stents in China in a 5.0-mm-diameter artificial blood vessel model by optical coherence tomography (OCT) in vitro. METHODS The left main coronary artery was simulated by a truncated cone-shaped silicone tube. The internal diameters were 4.0 mm at one end of the silicone tube and 5.0 mm at the other end. Six different types of coronary stents widely used in China were selected for this study. Each stent was respectively implanted into the simulated blood vessel and dilated to a diameter of 4.2 mm according to the stent-balloon pressure compliance table. The stents were subjected to post-dilatation with a 5.0 × 15-mm noncompliant balloon. The LSD ratio of the longitudinal axis of each stent and stent malapposition were measured through OCT, and any fractures of the stents were determined. RESULTS None of the six types of stents fractured following post-dilatation. The longitudinal axes of the BuMA and Excrossal stents were slightly shortened, while the other stents were elongated after high-pressure post-dilatation. All stents expanded to a diameter of 5.0 mm without incomplete stent apposition, except for the Nano Plus stent, which remained malapposed after high-pressure post-dilatation. CONCLUSION All 4.0-mm-diameter stents can be expanded to a diameter of 5.0 mm by noncompliant balloon post-dilatation without stent strut fracture. Most stents were found to be well apposed after high-pressure post-dilatation. However, LSD was observed after post-balloon dilatation. Stent malapposition might be positively correlated with the percentage change in stent length.
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Affiliation(s)
- Qing He
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yuqi Fan
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Zuojun Xu
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Junfeng Zhang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Du Y, Zhu B, Liu Y, Du Z, Zhang J, Yang W, Li H, Gao C. Association between apolipoprotein B/A1 ratio and quantities of tissue prolapse on optical coherence tomography examination in patients with atherosclerotic cardiovascular disease. Int J Cardiovasc Imaging 2024; 40:545-555. [PMID: 38198058 PMCID: PMC10950990 DOI: 10.1007/s10554-023-03023-5] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/22/2023] [Indexed: 01/11/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) continues to be a major health concern globally. Apolipoprotein (Apo) B/A1 ratio is a reliable predictor of ASCVD and an important factor in assessing the risk of myocardial infarction. Tissue prolapse (TP) is defined as the tissue extrusion into the lumen through the stent struts after implantation, which is a significant factor for poor short-term outcomes such as acute and subacute thrombosis, severe myocardial necrosis, and vulnerable plaque. Therefore, the aim of this study was to investigate the relationship between Apo B/A1, plaque vulnerability, and tissue prolapse on optical coherence tomography (OCT). This study enrolled 199 patients with atherosclerotic cardiovascular disease (ASCVD) who underwent percutaneous coronary intervention (PCI). Both pre- and post-procedural optical coherence tomography (OCT) examinations were conducted to assess TP volume and plaque morphology. Logistic regression analyses were performed to identify potential risk factors for tissue prolapse volume. Receiver operator characteristic (ROC) curve analysis was carried out to evaluate the value of the Apo B/A1 ratio for tissue prolapse volume. The high Apo B/A1 ratio group showed a larger TP volume (P = 0.001) and a higher percentage of plaque rupture and erosion in comparison to the low Apo B/A1 ratio group (P = 0.022 and P = 0.008). The high Apo B/A1 ratio group and the high TP volume group also had a higher proportion of thin-cap fibroatheroma (TCFA) (P = 0.046, P = 0.021). Multivariate logistic regression analysis revealed that both Apo B/A1 ratio (odds ratio [OR]: 1.041, 95% confidence interval [CI] 1.007-1.076; P = 0.019) and TCFA (OR: 3.199, 95%CI 1.133-9.031; 0.028) were significantly related to high TP volume. Furthermore, the area under the curve (AUC) for predictive value of TP volume was 0.635 for Apo B/A1 (95% CI 0.554-0.717, P = 0.002) compared to 0.615 for low density lipoprotein cholesterol (LDL-C) (95% CI 0.533-0.697, P = 0.008). The Apo B/A1 ratio is an independent predictor of TP volume on OCT and is related to plaque vulnerability.
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Affiliation(s)
- Yao Du
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Binbin Zhu
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Yahui Liu
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Zhou Du
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Jianhong Zhang
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Wei Yang
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Huiping Li
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China
| | - Chuanyu Gao
- Department of Cardiology, Zhengzhou University Central China Fuwai Hospital, No. 1 Fuwai Road, Zhengzhou, 451464, Henan, China.
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Imamura M, Yunoki K, Miyahara K, Oka T. Unusual optical coherence tomography findings resembling sea anemone tentacles after orbital atherectomy for nodular calcification lesions in a haemodialysis patient: a case report. Eur Heart J Case Rep 2024; 8:ytae095. [PMID: 38449781 PMCID: PMC10915290 DOI: 10.1093/ehjcr/ytae095] [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: 07/20/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
Background Optical coherence tomography (OCT) can be used to characterize the details of calcified plaques because it allows high-resolution evaluation of coronary plaques, thrombi, and calcium. Case summary A 72-year-old man on haemodialysis who had stenosis with a severe calcified lesion at the left anterior descending artery underwent percutaneous coronary intervention. Pre-intervention OCT imaging identified a nodular calcification (NC) that protruded into the lumen of the left anterior descending artery. To treat this lesion, we performed orbital atherectomy using the Diamondback 360 coronary orbital atherectomy system. After ablation of the nodular lesions at low and high speed, OCT showed newly emerged granular and filamentous structures that resembled sea anemone tentacles (these represented calcified nodule-like OCT findings). These structures appeared to extend from the proximal part of the ablated small NC, and shifted distally after balloon dilatation. Stent implantation was performed to entirely cover these structures, with no resulting complications. However, early in-stent restenosis occurred at 4 months follow-up. Discussion A tentacle-like OCT appearance in calcified lesions has not been previously reported. This represents a very rare and interesting imaging finding that reflects the relationship and origins of NCs and calcified nodules. The maturity of the NC lesions and the lateral sanding style of the orbital atherectomy system may have contributed to this striking OCT finding.
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Affiliation(s)
- Mayuko Imamura
- Department of Cardiology, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan
| | - Kei Yunoki
- Department of Cardiology, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan
| | - Katsunori Miyahara
- Department of Cardiology, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan
| | - Takefumi Oka
- Department of Cardiology, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan
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Wang B, Arbuckle RK, Davoli KA, Clinger OD, Brown R, Sahel JA, Chen Y, Pi S. Compensation of inner retina to early-stage photoreceptor degeneration in a Rho P23H/+ mouse model of retinitis pigmentosa. Exp Eye Res 2024; 240:109826. [PMID: 38340947 PMCID: PMC10940204 DOI: 10.1016/j.exer.2024.109826] [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: 12/01/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
Retinitis pigmentosa (RP) is an inherited retinal disorder characterized by the degeneration of photoreceptors. RhoP23H/+ mice, which carry a Pro23His mutation in the RHODOPSIN (Rho) gene, are one of the most studied animal models for RP. However, except for the photoreceptors, other retinal neural cells have not been fully investigated in this model. Here, we record the temporal changes of the retina by optical coherence tomography (OCT) imaging of the RhoP23H/+ mice, from early to mid-phase of retinal degeneration. Based on thickness analysis, we identified a natural retinal thickness adaption in wild-type mice during early adulthood and observed morphological compensation of the inner retina layer to photoreceptor degeneration in the RhoP23H/+ mice, primarily on the inner nuclear layer (INL). RhoP23H/+ mice findings were further validated via: histology showing the negative correlation of INL and ONL thicknesses; as well as electroretinogram (ERG) showing an increased b-wave to a-wave ratio. These results unravel the sequential morphologic events in this model and suggest a better understanding of retinal degeneration of RP for future studies.
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Affiliation(s)
- Bingjie Wang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Riley K Arbuckle
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, 15213, USA
| | - Katherine A Davoli
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Owen D Clinger
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Richard Brown
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Yuanyuan Chen
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
| | - Shaohua Pi
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA; UPMC Vision Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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Rinaldi R, Russo M, Bonanni A, Camilli M, Caffè A, Basile M, Salzillo C, Animati FM, Trani C, Niccoli G, Crea F, Montone RA. Short-term air pollution exposure and mechanisms of plaque instability in acute coronary syndromes: An optical coherence tomography study. Atherosclerosis 2024; 390:117393. [PMID: 38061973 DOI: 10.1016/j.atherosclerosis.2023.117393] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 03/06/2024]
Abstract
BACKGROUND AND AIMS Air pollution is emerging as an important risk factor for acute coronary syndrome (ACS). In this study, we investigated the association between short-term air pollution exposure and mechanisms of coronary plaque instability evaluated by optical coherence tomography (OCT) imaging in ACS patients. METHODS Patients with ACS undergoing OCT imaging were retrospectively selected. Mechanism of culprit lesion instability was classified as plaque rupture (PR) or intact fibrous cap (IFC) by OCT. Based on each case's home address, the mean daily exposures to several pollutants, including particulate matter 2.5 (PM2.5), on the same day of ACS and in the immediate days (up to 6 days) prior to the index ACS, were collected. RESULTS 139 ACS patients were included [69 (49.6%) had PR and 70 (50.4%) IFC]. Patients with PR, compared to those with IFC, had higher PM2.5 exposure levels on the same day of ACS, without differences in the immediate 6 days before index ACS. At multivariate analysis, PM2.5 exposure on the same day of ACS was the only independent predictor of PR [OR = 1.912 per SD (8.6 μg/m3), CI95 % (1.087-3.364), p = 0.025]. Patients with PR presented a steady increase in PM2.5 daily exposure levels in the days preceding the occurrence of ACS, with a peak the day of ACS (p for trend = 0.042) CONCLUSIONS: This study demonstrates for the first time that a higher short-term PM2.5 exposure, on the same day of ACS, is associated with an increased risk of PR as a pathobiological mechanism of coronary plaque instability.
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Affiliation(s)
- Riccardo Rinaldi
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Michele Russo
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiology, S. Maria Dei Battuti Hospital, AULSS 2 Veneto, Conegliano, TV, Italy
| | - Alice Bonanni
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Massimiliano Camilli
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Caffè
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Mattia Basile
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Carmine Salzillo
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Francesco Maria Animati
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Carlo Trani
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Filippo Crea
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rocco A Montone
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Kikuchi Y, Kawczynski MG, Anegondi N, Neubert A, Dai J, Ferrara D, Quezada-Ruiz C. Machine Learning to Predict Faricimab Treatment Outcome in Neovascular Age-Related Macular Degeneration. Ophthalmol Sci 2024; 4:100385. [PMID: 37868796 PMCID: PMC10585644 DOI: 10.1016/j.xops.2023.100385] [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] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 10/24/2023]
Abstract
Purpose To develop machine learning (ML) models to predict, at baseline, treatment outcomes at month 9 in patients with neovascular age-related macular degeneration (nAMD) receiving faricimab. Design Retrospective proof of concept study. Participants Patients enrolled in the phase II AVENUE trial (NCT02484690) of faricimab in nAMD. Methods Baseline characteristics and spectral domain-OCT (SD-OCT) image data from 185 faricimab-treated eyes were split into 80% training and 20% test sets at the patient level. Input variables were baseline age, sex, best-corrected visual acuity (BCVA), central subfield thickness (CST), low luminance deficit, treatment arm, and SD-OCT images. A regression problem (BCVA) and a binary classification problem (reduction of CST by 35%) were considered. Overall, 10 models were developed and tested for each problem. Benchmark classical ML models (linear, random forest, extreme gradient boosting) were trained on baseline characteristics; benchmark deep neural networks (DNNs) were trained on baseline SD-OCT B-scans. Baseline characteristics and SD-OCT data were merged using 2 approaches: model stacking (using DNN prediction as an input feature for classical ML models) and model averaging (which averaged predictions from the DNN using SD-OCT volume and from classical ML models using baseline characteristics). Main Outcome Measures Treatment outcomes were defined by 2 target variables: functional (BCVA letter score) and anatomical (percent decrease in CST from baseline) outcomes at month 9. Results The best-performing BCVA regression model with respect to the test coefficient of determination (R2) was the linear model in the model-stacking approach with R2 of 0.31. The best-performing CST classification model with respect to test area under receiver operating characteristics (AUROC) was the benchmark linear model with AUROC of 0.87. A post hoc analysis showed the baseline BCVA and the baseline CST had the most effect in the all-model prediction for BCVA regression and CST classification, respectively. Conclusions Promising signals for predicting treatment outcomes from baseline characteristics were detected; however, the predictive benefit of baseline images was unclear in this proof-of-concept study. Further testing and validation with larger, independent datasets is required to fully explore the predictive capacity of ML models using baseline imaging data. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Yusuke Kikuchi
- Roche Personalized Healthcare Program, Genentech, Inc., South San Francisco, California
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, Berkeley, California
| | - Michael G. Kawczynski
- Roche Personalized Healthcare Program, Genentech, Inc., South San Francisco, California
| | - Neha Anegondi
- Roche Personalized Healthcare Program, Genentech, Inc., South San Francisco, California
- Clinical Imaging Group, Genentech, Inc., South San Francisco, California
| | - Ales Neubert
- Data & Analytics, Roche Pharma Research and Early Development, Basel, Switzerland
| | - Jian Dai
- Roche Personalized Healthcare Program, Genentech, Inc., South San Francisco, California
| | - Daniela Ferrara
- Roche Personalized Healthcare Program, Genentech, Inc., South San Francisco, California
| | - Carlos Quezada-Ruiz
- Clinical Science, Genentech, Inc., South San Francisco, California
- Department of Ophthalmology, Clínica de Ojos Garza Viejo, San Pedro Garza, Garcia, Nuevo Leon, Mexico
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Hobelsberger S, Gellrich FF, Steininger J, Beissert S, Laske J. [ Optical coherence tomography for the diagnosis and differentiation of cutaneous cysts: a case series]. Dermatologie (Heidelb) 2024; 75:253-255. [PMID: 38110519 PMCID: PMC10891184 DOI: 10.1007/s00105-023-05274-8] [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] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/20/2023]
Abstract
Cutaneous cystic lesions (n = 35) were examined with optical coherence tomography. Cysts were visible as a hyporeflective roundish area with a clear margin; in some cases, the epidermis was thinned. Epidermal cysts, trichilemmal cysts, and hidrocystomas had a linear margin representing the epithelium of the cyst, whereas mucoid pseudocysts showed no linear margin. Trichilemmal and epidermal cysts presented with hyperreflective content that corresponds to keratin. By visualizing the margin and the content of the cyst, it was possible to differentiate between different types of cysts.
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Affiliation(s)
- Sarah Hobelsberger
- Department of Dermatology, Faculty of Medicine, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - Frank Friedrich Gellrich
- Department of Dermatology, Faculty of Medicine, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Julian Steininger
- Department of Dermatology, Faculty of Medicine, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Stefan Beissert
- Department of Dermatology, Faculty of Medicine, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Jörg Laske
- Department of Dermatology, Faculty of Medicine, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
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Varmpompiti K, Chow G, Foster M, Kodali S, Prados F, Yiannakas MC, Kanber B, Burke A, Ogunbowale L, Davagnanam I, Toosy AT, Collorone S. Associations between cortical lesions, optic nerve damage, and disability at the onset of multiple sclerosis: insights into neurodegenerative processes. Mult Scler Relat Disord 2024; 83:105413. [PMID: 38215633 DOI: 10.1016/j.msard.2023.105413] [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: 09/29/2023] [Revised: 12/12/2023] [Accepted: 12/25/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Multiple sclerosis cortical lesions are areas of demyelination and neuroaxonal loss. Retinal layer thickness, measured with optical coherence tomography (OCT), is an emerging biomarker of neuroaxonal loss. Studies have reported correlations between cortical lesions and retinal layer thinning in established multiple sclerosis, suggesting a shared pathophysiological process. Here, we assessed the correlation between cortical lesions and OCT metrics at the onset of multiple sclerosis, examining, for the first time, associations with physical or cognitive disability. OBJECTIVE To examine the relationship between cortical lesions, optic nerve and retinal layer thicknesses, and physical and cognitive disability at the first demyelinating event. METHODS Thirty-nine patients and 22 controls underwent 3T-MRI, optical coherence tomography, and clinical tests. We identified cortical lesions on phase-sensitive inversion recovery sequences, including occipital cortex lesions. We measured the estimated total intracranial volume and the white matter lesion volume. OCT metrics included peripapillary retinal nerve fibre layer (pRNFL), ganglion cell and inner plexiform layer (GCIPL) and inner nuclear layer (INL) thicknesses. RESULTS Higher total cortical and leukocortical lesion volumes correlated with thinner pRNFL (B = -0.0005, 95 % CI -0.0008 to -0.0001, p = 0.01; B = -0.0005, 95 % CI -0.0008 to -0.0001, p = 0.01, respectively). Leukocortical lesion number correlated with colour vision deficits (B = 0.58, 95 %CI 0.039 to 1,11, p = 0.036). Thinner GCIPL correlated with a higher Expanded Disability Status Scale (B = -0.06, 95 % CI -1.1 to -0.008, p = 0.026). MS diagnosis (n = 18) correlated with higher cortical and leukocortical lesion numbers (p = 0.004 and p = 0.003), thinner GCIPL (p = 0.029) and INL (p = 0.041). CONCLUSION The association between cortical lesions and axonal damage in the optic nerve reinforces the role of neurodegenerative processes in MS pathogenesis at onset.
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Affiliation(s)
- Kyriakoula Varmpompiti
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Geoffrey Chow
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Michael Foster
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Srikirti Kodali
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Ferran Prados
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK; Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, London, UK; eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Baris Kanber
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK; Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | | | | | - Indran Davagnanam
- Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
| | - Ahmed T Toosy
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Sara Collorone
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
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Estawro R, Abraham N, Fouad Y, Bousquet E, Sarraf D. Cystoid macular edema as a complication of central retinal artery occlusion. Am J Ophthalmol Case Rep 2024; 33:101998. [PMID: 38333032 PMCID: PMC10850887 DOI: 10.1016/j.ajoc.2024.101998] [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: 08/14/2023] [Revised: 11/15/2023] [Accepted: 01/12/2024] [Indexed: 02/10/2024] Open
Abstract
Purpose To describe the development of cystoid macular edema (CME) as a complication of central retinal artery occlusion (CRAO) in 2 cases. Observations The first patient was a 51-year-old female who presented with acute loss of vision in the left eye. Multimodal retinal imaging revealed a CRAO with a perfused cilioretinal artery. CME acutely developed one week after presentation. Cystoid spaces predominantly involved the outer nuclear layer (ONL) on optical coherence tomography (OCT) and completely resolved in two weeks. The second case was a 50-year-old man who presented with acute vision loss in the right eye for 3 weeks. Multimodal retinal imaging illustrated an acute CRAO of the right eye. Four weeks later, visual acuity spontaneously improved to 20/20 and was maintained at 20/20 for more than 2 years. After 28 months, the patient returned with a recurrent drop of vision in the right eye. Cross sectional and en face OCT revealed CME in the right eye without leakage on FA. Cystoid spaces predominantly involved the inner nuclear layer (INL) and resolved with intravitreal anti-VEGF injection combined with carbonic anhydrase inhibitor (CAI) and steroid topical drop therapy. Conclusions and Importance CME can rarely complicate both the acute and chronic phase of CRAO. In the acute phase, cystoid spaces were transient and confined to the ONL on OCT. While in the chronic phase, cystoid spaces were confined to the INL on OCT and angiographically silent on FA. Further studies are needed to identify the incidence, underlying pathophysiology and visual prognosis of CME in cases of CRAO.
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Affiliation(s)
- Rania Estawro
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States
- Retina Department, Al-Watany Eye Hospital, Cairo, Egypt
| | - Neda Abraham
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States
| | - Yousef Fouad
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States
- Department of Ophthalmology, Ain Shams University Hospitals, Cairo, Egypt
| | - Elodie Bousquet
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States
- Department of Ophthalmology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, United States
- Greater Los Angeles VA Healthcare Center, Los Angeles, CA, United States
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Friedel EBN, Tebartz van Elst L, Schäfer M, Maier S, Runge K, Küchlin S, Reich M, Lagrèze WA, Kornmeier J, Ebert D, Endres D, Domschke K, Nickel K. Retinal Thinning in Adults with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:1143-1156. [PMID: 36550331 PMCID: PMC10907434 DOI: 10.1007/s10803-022-05882-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
Since the retina shares its embryological origin with the central nervous system, optical coherence tomography (OCT), an imaging technique frequently employed in ophthalmology to analyze the macula and intraretinal layer thicknesses and volumes, has recently become increasingly important in psychiatric research. We examined 34 autistic and 31 neurotypical adults (NT) using OCT. Autistic adults had reduced overall macular and outer nuclear layer (ONL) thickness and volume compared to NT. Both macular and ONL thickness showed significant inverse associations with the severity of autistic symptoms measured with the Social Responsiveness Scale 2 (SRS-2). Longitudinal studies across different age groups are required to clarify whether retinal changes may represent a possible trait marker.
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Affiliation(s)
- Evelyn B N Friedel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mirjam Schäfer
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon Maier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Küchlin
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Reich
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wolf A Lagrèze
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Kornmeier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Katamine M, Minami Y, Asakura K, Nagata T, Katsura A, Muramatsu Y, Hashimoto T, Kinoshita D, Ako J. Body mass index and characteristics of coronary plaque in younger patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2024; 34:792-798. [PMID: 38218710 DOI: 10.1016/j.numecd.2023.12.009] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS The association between the body mass index (BMI) and the characteristics of coronary plaque in younger type 2 diabetes (T2D) patients with coronary artery disease (CAD) remains to be elucidated. METHODS AND RESULTS A total of 138 consecutive younger (<65 years) T2D patients with CAD, who underwent optical coherence tomography imaging of the culprit lesion were included. The patients were classified into either the higher BMI group (n = 68) or the lower BMI group (n = 70) according to the median of BMI (25.9 kg/m2). The prevalence of thin-cap fibroatheroma (TCFA) (35.3 vs. 17.1 %, p = 0.015) was significantly higher in the higher BMI group than in the lower BMI group. The prevalence of TCFA was significantly higher in patients with higher BMI than in those with lower BMI among patients with hemoglobin A1c (HbA1c) ≥7.0 % (odds ratio [OR] 5.40, 95 % confidence interval [CI] 1.72-17.0, p = 0.003) although the significant difference was not observed among patients with HbA1c <7.0 % (OR 0.89, 95 % CI 0.25-3.13, p = 0.851). CONCLUSION Higher BMI was associated with a higher prevalence of TCFA in younger T2D patients with CAD, particularly in patients with HbA1c ≥ 7.0 %.
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Affiliation(s)
- Masahiro Katamine
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiyasu Minami
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
| | - Kiyoshi Asakura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takako Nagata
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Aritomo Katsura
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yusuke Muramatsu
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takuya Hashimoto
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Daisuke Kinoshita
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Matos AMF, Defina RLS, Costa-Cunha LVF, Zacharias LC, Preti RC, Monteiro MLR, Cunha LP. Correlation between retinal sensitivity assessed by microperimetry and structural abnormalities on optical coherence tomography after successful epiretinal membrane surgery. Int J Retina Vitreous 2024; 10:24. [PMID: 38424619 PMCID: PMC10905782 DOI: 10.1186/s40942-024-00542-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND To verify the correlation between retinal sensitivity (RS) assessed by the microperimetry (MP) and optical coherence tomography (OCT) parameters measured in eyes submitted to pars-plana vitrectomy (PPV) for idiopathic epiretinal membrane (ERM) treatment. METHODS 43 patients underwent PPV. Best-corrected visual acuity (BCVA) and OCT imaging were acquired preoperatively and 6 months after surgery. The RS values were recorded 6 months after the surgery. Total macular thickness (TMT) measurements and OCT-evaluated structural findings were also analyzed. The MP examination tested 44 points, with direct topographic correspondence with the OCT-ETDRS map. Correlations between BCVA, RS, and OCT parameters were assessed. RESULTS TMT measurements in patients were significantly thicker preoperatively and reduced after surgery. All patients demonstrated BCVA improvements after surgery. The RS parameters after surgery were significantly lower in patients. For OCT structural analyses, patients with lower RS at the fovea correlated with the preexisting disorganization of retinal inner layers (DRIL). In addition, lower RS values were associated with DRIL, outer retinal changes (ORC), and intraretinal microcysts after surgery. CONCLUSIONS The RS values after surgery were significantly lower when compared to controls. The DRIL presence before and after surgery, and microcysts and ORC after surgery were related to worse visual outcomes.
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Affiliation(s)
- Aline Mota Freitas Matos
- Division of Ophthalmology, Federal University of Juiz de Fora Medical School, Avenida Barão do Rio Branco, 4051. Bom Pastor, Juiz de Fora, Minas Gerais, 36021-630, Brazil
- Juiz de Fora Eye Hospital, Juiz de Fora, Minas Gerais, Brazil
| | - Raphael Lucas Sampaio Defina
- Division of Ophthalmology, Federal University of Juiz de Fora Medical School, Avenida Barão do Rio Branco, 4051. Bom Pastor, Juiz de Fora, Minas Gerais, 36021-630, Brazil
| | | | - Leandro Cabral Zacharias
- Division of Ophthalmology and the Laboratory of Investigation in Ophthalmology (LIM 33), University of São Paulo Medical School, São Paulo, Brazil
| | - Rony Carlos Preti
- Division of Ophthalmology and the Laboratory of Investigation in Ophthalmology (LIM 33), University of São Paulo Medical School, São Paulo, Brazil
| | - Mário Luiz Ribeiro Monteiro
- Division of Ophthalmology and the Laboratory of Investigation in Ophthalmology (LIM 33), University of São Paulo Medical School, São Paulo, Brazil
| | - Leonardo Provetti Cunha
- Division of Ophthalmology, Federal University of Juiz de Fora Medical School, Avenida Barão do Rio Branco, 4051. Bom Pastor, Juiz de Fora, Minas Gerais, 36021-630, Brazil.
- Juiz de Fora Eye Hospital, Juiz de Fora, Minas Gerais, Brazil.
- Division of Ophthalmology and the Laboratory of Investigation in Ophthalmology (LIM 33), University of São Paulo Medical School, São Paulo, Brazil.
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Liu L, Xu Q, Song X, Zhao Y, Zhang Y, Qu Y. Evaluation of changes in macular structures after subthreshold micropulse laser therapy on chronic central serous chorioretinopathy. Lasers Med Sci 2024; 39:83. [PMID: 38418639 DOI: 10.1007/s10103-024-04030-1] [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: 03/16/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To evaluate the changes in macular structures following subthreshold micropulse laser (SHML) treatment for chronic central serous chorioretinopathy (cCSC). METHODS Data of 33 eyes from 31 cCSC patients treated with SHML and followed up for at least 6 months has been included in this retrospective study. Main outcome measurements include resolution of subretinal fluid (SRF) and pigment epithelial detachment (PED), the recovery of ellipsoid zone (EZ) continuity, and the foveal outer nuclear layer (ONL) thickness along with its ratio. RESULTS Mean observation period is 7.355 months (ranging from 6 to 24 months) and mean number of treatments administered is 1.839 (ranging from 1 to 5). 6 months after SHML treatment, there is a significant decrease in the area of SRF and PED (P < 0.001, P = 0.010, respectively). Additionally, the frequency of continuous EZ and the foveal ONL thickness reveal a significant increase (P<0.001, P = 0.005, respectively). The ratio of foveal ONL thickness is significantly higher after laser treatment, particularly in patients with a disease duration of ≤12 months (p = 0.022, P=0.036, respectively). CONCLUSION SHML treatment proves to be effective in cCSC eyes, leading to satisfactory recovery of macular structures, especially the photoreceptor layer.
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Affiliation(s)
- Lijun Liu
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Qian Xu
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Xian Song
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Yuqing Zhao
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Yu Zhang
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Yi Qu
- Department of Geriatrics, Qilu Hospital of Shandong University, Wenhuaxi Road, Jinan, Shandong, 250012, China.
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Zhang W, Shen Y, Liu Z, Gu N, Rong J, Deng C, Wang X, Deng Y, Ma S, Yang S, Chen L, Hu X, Zhao Y, Zhao R, Shi B. Morphological characteristics of in-stent restenosis with different degrees of area stenosis: an optical coherence tomography study. Int J Cardiovasc Imaging 2024:10.1007/s10554-023-03017-3. [PMID: 38416297 DOI: 10.1007/s10554-023-03017-3] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/20/2023] [Indexed: 02/29/2024]
Abstract
The morphological characteristics of in-stent restenosis (ISR) in relation to varying degrees of area stenosis have not been comprehensively examined. This study aimed to explore the tissue characteristics of patients experiencing ISR with different degrees of area stenosis through the utilization of optical coherence tomography (OCT). In total, 230 patients with ISR who underwent OCT were divided into the following three groups: area stenosis (AS) < 70% (n = 26); 70-80% (n = 119) and AS ≥ 80% (n = 85). Among the 230 patients, the clinical presentation as stable angina was 61.5% in AS < 70%, followed by 47.2% in 70% < AS ≤ 80%, and 31.8% in AS ≥ 80% (P = 0.010). The OCT findings showed that heterogeneous neointima, ISNA, LRP, neointima rupture, TCFA-like pattern, macrophage infiltration, red and white thrombus was more common with AS increased. Ordinal logistic regression analysis showed that higher AS was associated with previous dyslipidemia (odds ratio [OR], 4.754; 95% confidence interval [CI], 1.419-15.927, P = 0.011), neointimal rupture (OR: 3.640; 95% CI, 1.169-11.325, P = 0.026), red thrombus (OR: 4.482; 95% CI, 1.269-15.816, P = 0.020) and white thrombus (OR: 5.259; 95% CI, 1.660-16.659, P = 0.005). Patients with higher degrees of area stenosis in the context of ISR exhibited a greater number of discernible morphological characteristics as identified through OCT analysis. Furthermore, previous dyslipidemia, neointimal rupture, white thrombus and red thrombus were highly associated with and the progression of ISR lesions.
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Affiliation(s)
- Wei Zhang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Youcheng Shen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Zhijiang Liu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Ning Gu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Jidong Rong
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Chancui Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Xi Wang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Yi Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Shuai Ma
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Shuangya Yang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Lei Chen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Xingwei Hu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Yongchao Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Ranzhun Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China.
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Maruko I, Maruko R, Kawano T, Iida T. Comparisons of choroidal thickness and volume in eyes with central serous chorioretinopathy to that of control eyes determined by ultra-widefield optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06409-w. [PMID: 38413447 DOI: 10.1007/s00417-024-06409-w] [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: 08/31/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 02/29/2024] Open
Abstract
PURPOSE To compare choroidal thickness and volume in eyes with central serous chorioretinopathy (CSC) and healthy control eyes over a wide area of the fundus using ultra-widefield optical coherence tomography (UWF-OCT). METHODS Thirty-three eyes of 29 patients with CSC and 36 eyes of 21 healthy controls were examined retrospectively. Choroidal images were obtained with a prototype UWF-OCT device with a field of view of 105° or approximately 31.5-mm wide by 10.9-mm deep. Choroidal thickness and volume were measured in the images of 12 radial scans (every 15°) from the horizontal scan. The "new index" of the extent of focal choroidal protrusion was defined as the maximum steepness of choroidal thickness (MSCT). RESULTS Choroidal volume in CSC eyes was significantly larger than in control eyes within the central 50° (P < 0.001). However, there was no significant difference in choroidal volume in the peripheral 50 to 105° (P = 0.071). The MSCTs were significantly steeper in CSC eyes than in control eyes at scan lines 1, 6, 7, 8, and 10 (P < 0.01, P < 0.001, P < 0.05, P < 0.01, P < 0.05). CONCLUSIONS The choroid in CSC eyes was thickened only at the posterior pole, and its protrusion was significant mainly in the vertical direction. Focal choroidal thickening at the posterior pole, which we speculate includes congenital scleral changes, may affect the pathophysiology of CSC.
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Affiliation(s)
- Ichiro Maruko
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Ruka Maruko
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Taizo Kawano
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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