1
|
Paczwa K, Rerych M, Romanowska-Próchnicka K, Olesińska M, Różycki R, Gołębiewska J. Retinal Microvasculature in Systemic Sclerosis Patients and the Correlation between Nailfold Capillaroscopic Findings and Optical Coherence Angiography Results. J Clin Med 2024; 13:2025. [PMID: 38610789 PMCID: PMC11012647 DOI: 10.3390/jcm13072025] [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: 02/27/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The comparison of retinal perfusion in the eyes of patients with systemic sclerosis (SSc) and in healthy controls using optical coherence tomography angiography (OCTA). The correlation between nailfold capillaroscopy results and OCTA findings among SSc. Methods: The study enrolled 31 patients with systemic sclerosis and 41 healthy controls. OCTA was performed in both groups to assess the retinal vasculature in the superficial (SCP) and deep (DCP) capillary plexuses and the foveal avascular zone (FAZ) area. Nailfold capillaroscopy (NC) was performed in SSc patients and compared to the FAZ area and the superficial and the deep vessel density. Results: In the SSc group, the parafoveal vessel density in DCP was significantly higher in relation to the mean value (p < 0.0001) and in each quadrant of the macula (p < 0.0001) compared to healthy subjects (p < 0.0001). The patients with early scleroderma patterns in capillaroscopy had a larger superficial and deep FAZ (p = 0.0104, p = 0.0076, respectively) than those with active and late patterns. There was a statistically significant difference in the FAZ when comparing early to active (p < 0.0001) and early to late scleroderma patterns (p < 0.0001). A statistically significant difference was found in the type of interstitial lung disease and the deep FAZ area (p = 0.0484). SSc patients with nonspecific interstitial pneumonia (NSIP) had a larger FAZ than those with usual interstitial pneumonia (UIP) (p = 0.0484). Moreover, NSIP cases had a higher parafoveal mean superficial vessel density than those with UIP (p = 0.0471). Conclusions: Our investigation showed that the peripheral microvascular system correlates with ocular microcirculatory impairment. The results indicate the important role of OCTA in the diagnosis, monitoring, and prognosis of microvascular changes in SSc.
Collapse
Affiliation(s)
- Katarzyna Paczwa
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| | - Magdalena Rerych
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| | - Katarzyna Romanowska-Próchnicka
- Department and Polyclinic of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Marzena Olesińska
- Department and Polyclinic of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Radosław Różycki
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| | - Joanna Gołębiewska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland (M.R.)
| |
Collapse
|
2
|
Podraza K, Bangera N, Feliz A, Charles A. Reduction in retinal microvascular perfusion during migraine attacks. Headache 2024; 64:16-36. [PMID: 38031892 DOI: 10.1111/head.14654] [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: 07/23/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To determine if there are changes in structure and function of the retinal vasculature during and between migraine attacks using optical coherence tomography angiography (OCTA). BACKGROUND Migraine attacks commonly include visual symptoms, but the potential role of the retina in these symptoms is not well understood. OCTA is a rapid, non-invasive imaging technique that is used to visualize the retinal microvasculature with high spatial resolution in a clinical setting. In this study we used OCTA to quantify different features of the retinal vasculature in patients with migraine during and between attacks, as well as in healthy controls (HCs). METHODS We performed a prospective cohort study of 37 patients with migraine with aura (MA) (median [interquartile range, IQR] age of 37 [14] years, 86% female) and 30 with migraine without aura (MO) (median [IQR] age of 37 [17] years, 77% female) and 20 HCs (median [IQR] age of 35 [7] years, 50% female). Macular OCTA scans were obtained for all participants for the interictal analysis. In 12 MA and eight MO, scans were captured both during and outside of migraine attacks and five HCs had initial and repeat scans. In addition to analyzing the morphology of the foveal avascular zone, we calculated the vessel flux index (VFI), which is an indicator of retinal perfusion and conventional metrics (such as vessel area density) in the foveal and parafoveal regions. RESULTS There was a significant difference in the parafoveal VFI in the ictal state between the groups (p = 0.009). During migraine attacks there was a significant reduction in the parafoveal region VFI in MA (-7%, 95% confidence interval [CI] -10% to -4%; p = 0.006) and MO (-7%, 95% CI -10% to -3%; p = 0.016) from their interictal baseline as compared to the change between repeat scans in HCs (2%, 95% CI -3% to 7%). Interictally, there was a mean (standard deviation [SD]) 13% (10%) (p = 0.003) lower blood perfusion in the MA group as compared to the MO group in the foveal region (mean [SD] 0.093 [0.023] vs. 0.107 [0.021], p = 0.003). Interictal analysis also revealed higher circularity in the superficial foveal avascular zone in the MA group compared with the MO group (mean [SD] 0.686 [0.088] vs. 0.629 [0.120], p = 0.004). In addition, interictal analysis of the patients with MA or MO and unilateral headache showed increased retinal vascular parameters consistent with greater perfusion in the eye ipsilateral to the side of the pain as compared with the contralateral eye. CONCLUSIONS These results indicate that perfusion is reduced in MA and MO in the parafoveal retina during the ictal period. Interictally, the foveal retina in MA has reduced perfusion when compared to the foveal retina in MO. Patients with unilateral headache showed interictal asymmetry of retinal perfusion between eyes. These results indicate that changes in retinal perfusion could be a part of migraine pathophysiology, and that distinct retinal vascular signatures identified with OCTA could represent biomarkers for migraine.
Collapse
Affiliation(s)
- Katherine Podraza
- Department of Neurology, University of California, Los Angeles, California, USA
- Hartford Healthcare Headache Center, Mystic, Connecticut, USA
| | - Nitin Bangera
- Department of Neurology, University of California, Los Angeles, California, USA
- Center for Advanced Diagnostics, Evaluation and Therapeutics (CADET NM Inc.), Albuquerque, New Mexico, USA
| | - Akira Feliz
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Andrew Charles
- Department of Neurology, University of California, Los Angeles, California, USA
| |
Collapse
|
3
|
Jiang H, Liu Z, Townsend JH, Wang J. Effects of Methylenetetrahydrofolate Reductase ( MTHFR) Polymorphisms on Retinal Tissue Perfusion in Mild Diabetic Retinopathy Patients Receiving the Medical Food, Ocufolin ®. Clin Ophthalmol 2023; 17:1121-1127. [PMID: 37077224 PMCID: PMC10106310 DOI: 10.2147/opth.s401743] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/27/2023] [Indexed: 04/21/2023] Open
Abstract
Purpose We evaluate the effects of methylenetetrahydrofolate reductase (MTHFR) polymorphisms on retinal tissue perfusion in patients with mild diabetic retinopathy (DR + PM) taking the medical food, Ocufolin®, for 6 months. Methods Prospective, case-controlled study. Eight early diabetic retinopathy patients with common reduced function MTHFR polymorphisms (DR+PM) and 15 normal controls (NC) were recruited. MTHFR polymorphisms were subtyped as normal, C677T, or A1298C. Best corrected visual acuity (BCVA) was evaluated. Retinal blood flow velocity (BFV) was measured using Retinal Function Imager. Retinal tissue perfusion (RTP, blood flow rate per inner retinal volume) was calculated within a 2.5 mm diameter circle centered on the fovea. The medical food is intended to address ocular ischemia with high doses of vitamin B-complexes and antioxidants, including L-methylfolate, methylcobalamin, zinc, copper, lutein, vitamins C, D, E, and n-acetylcysteine. The subjects were provided with a medical food for a period of 6 months. Results BCVA and vascular indices of DR + PM patients at baseline were initially below those of NC and improved after medical food. Compared to baseline, DR + PM patients after the medical food had significantly improved BCVA during the follow-up period (P < 0.05). In comparison, overall RTP and arteriolar BFV were significantly increased at 6 months (P < 0.05). The changes varied with MTHFR subtypes. In patients with the C677T and the C677T/A1298C compound mutations, RTP was increased at 6 months as compared to that at baseline and 4 months (P < 0.05). In patients with only the A1298C mutation, all microcirculation metrics were increased from baseline at 4 and 6 months, but with less improvement at 6 months than at 4 months (P < 0.05). Conclusion Medical food was effective in improving both visual acuity and retinal tissue perfusion in DR + PM patients. The degree of improvement of retinal microcirculation varied among MTHFR subtypes.
Collapse
Affiliation(s)
- Hong Jiang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zhiping Liu
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Ophthalmic Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Justin H Townsend
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jianhua Wang
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Correspondence: Jianhua Wang, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building - Room 202A, Miami, FL, 33136, USA, Tel +1 305 482-5010, Fax +1 305 482-5012, Email
| |
Collapse
|
4
|
Abstract
The high prevalence of myopia has become a global concern, especially in East and Southeast Asia. Alarmingly, the prevalence of high myopia is increasing. Mechanical stretching caused by excessive eyeball elongation leads to various anatomical changes in the fundus. This stretching force may also lead to the development of vascular abnormalities, which tend to be subtle and easily overlooked. A healthy ocular vasculature is a prerequisite of adequate oxygen supply for normal retinal functions. This review summarises previous findings on structural and haemodynamic aspects of myopia-related vascular changes.
Collapse
Affiliation(s)
- Mei Zhao
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Andrew Kc Lam
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Allen My Cheong
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| |
Collapse
|
5
|
Prasuhn M, Miura Y, Tura A, Rommel F, Kakkassery V, Sonntag S, Grisanti S, Ranjbar M. Influence of Retinal Microsecond Pulse Laser Treatment in Central Serous Chorioretinopathy: A Short-Term Optical Coherence Tomography Angiography Study. J Clin Med 2021; 10:jcm10112418. [PMID: 34072472 PMCID: PMC8198696 DOI: 10.3390/jcm10112418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 02/03/2023] Open
Abstract
Background: Central serous chorioretinopathy (CSC) is a common macular condition characterized by detachment of the neuroretina and is a frequent cause of central vision loss in adults. Among the various therapeutic strategies, subthreshold microsecond pulsed laser (SML) treatment has become a useful option. Despite the suggested involvement of choroidal circulatory disturbances in CSC, the effects of this treatment on macular microperfusion have not been fully evaluated yet. Herein, we report the impact of SML on retinal and choroidal microvascular flow using non-invasive optical coherence tomography (OCT) angiography (OCTA). Methods: In this study, CSC patients with persistent subretinal fluid (SRF) with or without secondary choroidal neovascularization (CNV) were included (referred to as the pachychoroid neovasculopathy (PNV) group and the CSC group, respectively). SML was conducted using a yellow (577 nm) laser with a duty cycle of 10%, spot size of 200 µm and duration of 200 ms. Best corrected visual acuity (BCVA) as well as OCT and OCTA images were evaluated at baseline and 4 weeks after SML. OCTA parameters of interest included full retinal perfusion (FRP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion (HLP), which were evaluated longitudinally and compared to unaffected fellow eyes. Results: 27 affected eyes and 17 fellow eyes from 27 patients were included. Before treatment, central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) of affected eyes were significantly larger than in fellow eyes. Four weeks after SML, CRT decreased significantly, whereas perfusion parameters did not change. In subgroup analyses, the CSC group showed a significant decrease in SFCT, whereas the PNV group did not despite the decrease in CRT. Conclusion: Our results suggest that the SML may affect the SFCT of the CSC, but not the PNV patients at least within four weeks following treatment. This effect seems to be independent of the change in choroidal perfusion measured with OCTA.
Collapse
Affiliation(s)
- Michelle Prasuhn
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
- Laboratory for Angiogenesis & Ocular Cell Transplantation, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Correspondence: (M.P.); (Y.M.); Tel.: +49-451-3101-3212 (Y.M.)
| | - Yoko Miura
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
- Institute of Biomedical Optics, University of Lübeck, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
- Correspondence: (M.P.); (Y.M.); Tel.: +49-451-3101-3212 (Y.M.)
| | - Aysegül Tura
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
| | - Felix Rommel
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
- Laboratory for Angiogenesis & Ocular Cell Transplantation, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Vinodh Kakkassery
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
| | - Svenja Sonntag
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
| | - Salvatore Grisanti
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
| | - Mahdy Ranjbar
- Department of Ophthalmology, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; (A.T.); (F.R.); (V.K.); (S.S.); (S.G.); (M.R.)
- Laboratory for Angiogenesis & Ocular Cell Transplantation, University Hospital Schleswig-Holstein, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| |
Collapse
|
6
|
Brinkmann MP, Kibele NX, Prasuhn M, Kakkassery V, Toro MD, Ranjbar M, Grisanti S, Becker M, Rommel F. Evaluating Retinal and Choroidal Perfusion Changes after Isometric and Dynamic Activity Using Optical Coherence Tomography Angiography. Diagnostics (Basel) 2021; 11:diagnostics11050808. [PMID: 33947000 PMCID: PMC8146969 DOI: 10.3390/diagnostics11050808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/30/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the retinal and choroidal perfusion state in vivo. This study aimed to evaluate the acute effects of isometric and dynamic exercise on retinal and choroidal sublayer perfusion using OCTA. A pilot study was conducted on young, healthy participants, each of whom performed a specific isometric exercise on the first day and a dynamic exercise the day after. At baseline and immediately after the exercise, heart rate (HR), mean arterial pressure (MAP), superficial capillary plexus perfusion (SCPP), deep capillary plexus perfusion (DCPP), choriocapillaris perfusion (CCP), Sattlers’s layer perfusion (SLP), and Haller’s layer perfusion (HLP) were recorded. A total of 34 eyes of 34 subjects with a mean age of 32.35 ± 7.87 years were included. HR as well as MAP increased significantly after both types of exercise. Both SCPP and DCPP did not show any significant alteration due to isometric or dynamic exercise. After performing dynamic exercise, CCP, SLP, as well as HLP significantly increased. Changes in MAP correlated significantly with changes in HLP after the dynamic activity. OCTA-based analysis in healthy adults following physical activity demonstrated a constant retinal perfusion, supporting the theory of autoregulatory mechanisms. Dynamic exercise, as opposed to isometric activity, significantly changed choroidal perfusion. OCTA imaging may represent a novel and sensitive tool to expand the diagnostic spectrum in the field of sports medicine.
Collapse
Affiliation(s)
- Max Philipp Brinkmann
- Department of Ophthalmology, Stadtspital Waid und Triemli Zürich, 8063 Zürich, Switzerland; (M.P.B.); (N.X.K.); (M.B.)
- Department of Ophthalmology, Klinikum Klagenfurt, A-9020 Klagenfurt, Austria
| | - Nikolas Xavier Kibele
- Department of Ophthalmology, Stadtspital Waid und Triemli Zürich, 8063 Zürich, Switzerland; (M.P.B.); (N.X.K.); (M.B.)
| | - Michelle Prasuhn
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Vinodh Kakkassery
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Mario Damiano Toro
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
- Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, 01815 Warsaw, Poland
- Correspondence: (M.D.T.); (F.R.); Tel.: +49-451-500-43952 (F.R.)
| | - Mahdy Ranjbar
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Salvatore Grisanti
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
| | - Matthias Becker
- Department of Ophthalmology, Stadtspital Waid und Triemli Zürich, 8063 Zürich, Switzerland; (M.P.B.); (N.X.K.); (M.B.)
- Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Felix Rommel
- Department of Ophthalmology, University of Lübeck, 23538 Lübeck, Germany; (M.P.); (V.K.); (M.R.); (S.G.)
- Correspondence: (M.D.T.); (F.R.); Tel.: +49-451-500-43952 (F.R.)
| |
Collapse
|
7
|
Yang Y, Zhang G, Zhang S, Bian X, Qi L, Guo S, Zhang B, Liu L. Quantitative Analysis of the Macular and Peripapillary Capillary Network with Optical Coherence Tomography Angiography in Chinese Adolescents: The Tuyou County Pediatric Eye (TYPE) Study. Int J Gen Med 2021; 14:371-379. [PMID: 33574695 PMCID: PMC7872928 DOI: 10.2147/ijgm.s293560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/14/2021] [Indexed: 12/18/2022] Open
Abstract
Aim To use OCTA to collect normative data describing the vascular perfusion of the macula and optic disc in adolescents. Methods This cross-sectional, school-based study was conducted from Oct 15, 2019, to Nov 30, 2019, in Tuyou County, Baotou, China. All eligible participants underwent a comprehensive questionnaire and ocular examination. The vascular perfusion of the macula and optic disc was determined using a spectral-domain OCTA device. Results A total of 570 anatomically normal eyes without a history of pathologic disease from 570 adolescents (mean ± SD age, 15.1 ± 1.9 years; 298 girls [52.3%]) were enrolled. In the macula, the mean ± SD perifoveal perfusion density (PD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was 44.2% ± 4.37% and 50.74% ± 3.98%, respectively. The mean ± SD foveal avascular zone (FAZ) was 0.32 mm2 ± 0.11 mm2. The mean ± SD peripapillary vessel density (PVD) was 54.98% ± 3.53%. The inferior hemiretinal SCP-PD, DCP-PD, FAZ, and PVD was larger in girls than boys (P = 0.006, P = 0.001, P < 0.001, and P = 0.006, respectively) Multiple regression analysis confirmed that sex independently affected the DCP-PD, FAZ, and PVD (P < 0.001, P < 0.001, and P = 0.029, respectively) and that axial length (AL) independently affected the FAZ area and PVD (P = 0.004 and P < 0.001, respectively). Conclusion Quantitative studies of the perifoveal vasculature in adolescents should consider the patient’s sex and AL. Our findings may provide useful information for the understanding and the management of retinal perfusion in Chinese adolescents.
Collapse
Affiliation(s)
- Yajun Yang
- Cataract Department, Baotou Chaoju Eye Hospital, Baotou, 014060, People's Republic of China
| | - Guisen Zhang
- Retina Department, Hohhot Chaoju Eye Hospital, Hohhot, 010050, People's Republic of China
| | - Song Zhang
- Cataract Department, China Medical University, Shenyang, 110122, People's Republic of China
| | - Xiaoyan Bian
- Cataract Department, Baotou Chaoju Eye Hospital, Baotou, 014060, People's Republic of China
| | - Lao Qi
- Retina Department, Hohhot Chaoju Eye Hospital, Hohhot, 010050, People's Republic of China
| | - Shixuan Guo
- Retina Department, Hohhot Chaoju Eye Hospital, Hohhot, 010050, People's Republic of China
| | - Bozhou Zhang
- Cataract Department, Baotou Chaoju Eye Hospital, Baotou, 014060, People's Republic of China
| | - Lei Liu
- Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| |
Collapse
|
8
|
Rommel F, Lüken S, Prasuhn M, Kurz M, Kakkassery V, Grisanti S, Ranjbar M. Evaluating Retinal and Choroidal Perfusion Changes After Ocular Massage of Healthy Eyes Using Optical Coherence Tomography Angiography. ACTA ACUST UNITED AC 2020; 56:medicina56120645. [PMID: 33255873 PMCID: PMC7761025 DOI: 10.3390/medicina56120645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/08/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
Background and objectives: Ocular massage (OM) is used as a treatment option for acute retinal artery occlusion, under the assumption that it induces vessel dilatation and enhances perfusion. Since evidence of ocular perfusion alteration due to OM is lacking, we investigate the impact of OM on the hemodynamics of the posterior pole in healthy eyes in a noninvasive fashion by using optical coherence tomography angiography (OCTA). Materials and Methods: A prospective study was conducted on healthy volunteers, each of whom underwent measurements of intraocular pressure (IOP), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), radial peripapillary capillary perfusion (RPCP), superficial capillary plexus perfusion (SCPP), deep capillary plexus perfusion (DCPP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP) and Haller’s layer perfusion (HLP) before and after OM. OM was performed for 2 min, consisting of 10-s turns of compression and decompression of the globe. Results: A total of 21 eyes from 21 participants (median age 29) were included. After OM, IOP significantly declined (p < 0.001), while SFCT (p < 0.005), SCPP (p < 0.001), DCPP (p = 0.004) and CCP (p = 0.008) significantly increased. CMT, RPCP, SLP and HLP did not show any significant alteration due to OM. Changes in SCPP correlated positively with changes in CCP and vice versa. Conclusions: OCTA-based analysis in healthy adults following OM demonstrated a significant increase of retinal perfusion values, assumed to be due to failure of autoregulatory mechanisms. These findings may indicate a positive effect of OM as a treatment option for patients with acute retinal artery occlusion.
Collapse
|
9
|
Sundar MD, Dewan L, Chawla R, Kumar A, Hasan N. Three-years follow-up swept source optical coherence tomography angiography findings in post-fever retinitis. Indian J Ophthalmol 2020; 68:2024-2028. [PMID: 32823467 PMCID: PMC7690496 DOI: 10.4103/ijo.ijo_2031_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/04/2022] Open
Abstract
Post fever retinitis (PFR), characterized by multiple cotton wool spot like lesions in the posterior pole, is commonly reported following viral and bacterial infections. Retinal perfusion defects have been documented with the help of optical coherence tomography angiography (OCTA) in cases of PFR. But long term changes in such cases have not been reported earlier. In the following report, we have described the swept-source OCTA findings of two PFR patients at initial presentation and three years follow-up. Initial OCTA scans may not provide accurate information regarding the perfusion status due to associated retinal edema and inflammation. However, persisting perfusion defects at the superficial and deep retinal capillary plexus were noted on long term follow-up in both the cases.
Collapse
Affiliation(s)
- M Dheepak Sundar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lubhavni Dewan
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Nasiq Hasan
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
10
|
Khan MH, Lam AKC, Armitage JA, Hanna L, To CH, Gentle A. Impact of Axial Eye Size on Retinal Microvasculature Density in the Macular Region. J Clin Med 2020; 9:jcm9082539. [PMID: 32781548 PMCID: PMC7463769 DOI: 10.3390/jcm9082539] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 06/26/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 01/21/2023] Open
Abstract
Mechanical tissue stresses are important contributors to the increased risk of sight-threatening pathology in larger, more myopic eyes. The contribution of altered ocular vasculature to the development of this pathology is less well defined. The current study investigated the impact of eye size on the superficial vasculature of the macula. Subjects (n = 104) aged 18–50, with no history of ocular or vascular disease, or myopia control, were recruited from university staff and student populations in Australia and Hong Kong. Refractive error, ocular size, retinal morphology and vascular morphology were quantified through open field autorefraction, ocular biometry and ocular coherence tomography angiography. Morphology of the superficial retinal capillary plexus was assessed over a 3 × 3 mm fovea-centred area. Perfusion area and vessel length densities were analysed relative to axial eye length and retinal thickness. A significant inverse association was found between axial length and vascular density measures (perfusion area density r2 = 0.186, p < 0.001; and vessel length density r2 = 0.102, p = 0.001). Perfusion area and vessel length densities were reduced by 5.8% (p = 0.001) in the longest, relative to the shortest, eyes. The aggregated ganglion cell layer inner plexiform layer thickness was also inversely associated with eye size (r2 = 0.083, p = 0.003), and reduced, by 8.1% (p < 0.001), in the longest eyes. An inverse association of eye size and superficial retinal vasculature density, that is not simply explained by retinal expansion or image magnification factors, was confirmed. These data support the hypothesis that ongoing metabolic challenges may underlie the development of myopia-related and -associated pathology in larger eyes.
Collapse
Affiliation(s)
- M. Hafi Khan
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (M.H.K.); (J.A.A.)
| | - Andrew K. C. Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong 00852, China; (A.K.C.L.); (C.-h.T.)
| | - James A. Armitage
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (M.H.K.); (J.A.A.)
| | - Lisa Hanna
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia;
| | - Chi-ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong 00852, China; (A.K.C.L.); (C.-h.T.)
| | - Alex Gentle
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (M.H.K.); (J.A.A.)
- Correspondence:
| |
Collapse
|
11
|
Rommel F, Brinkmann MP, Sochurek JAM, Prasuhn M, Grisanti S, Ranjbar M. Ocular Blood Flow Changes Impact Visual Acuity Gain after Surgical Treatment for Idiopathic Epiretinal Membrane. J Clin Med 2020; 9:jcm9061768. [PMID: 32517301 PMCID: PMC7356826 DOI: 10.3390/jcm9061768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/03/2020] [Revised: 05/19/2020] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Idiopathic epiretinal membrane (iERM) is a common eye disease, which can be treated by surgical removal of the fibrotic tissue. Morphological outcome is generally evaluated by optical coherence tomography (OCT). Here, we investigate the impact of surgery on hemodynamics of the posterior pole, using OCT angiography (OCTA). Methods: Patients with unilateral iERM and indication for treatment were included. OCT and OCTA images of the posterior pole were obtained preoperatively and 3-months after 23G vitrectomy with membrane peeling. Parameters of interest included full retinal perfusion, choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion, which were evaluated longitudinally and also compared to unaffected fellow eyes. Using these parameters, multiple regression analyses were used to predict visual outcomes. Results: Sixty-three iERM eyes were recruited, which initially showed a significant bigger central retinal thickness (p < 0.001) and total macular volume (TMV) (p < 0.001) compared to fellow eyes, while perfusion parameters were alike. Three months later, treated eyes had a statistically significant thicker subfoveal choroid (p = 0.006) and showed an increase of CCP (p = 0.003), while SLP decreased (p = 0.014). Lower preoperative TMV and higher SLP were associated with better postoperative visual outcome. Conclusion: In this OCTA study, iERM itself does not affect the choroidal circulation. However, preoperative choroidal circulation will be a biomarker to know the influence on the choroidal circulation after ERM surgery and may be considered as a predictor for visual outcome.
Collapse
Affiliation(s)
- Felix Rommel
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.); (S.G.); (M.R.)
- Laboratory for Angiogenesis & Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.B.); (J.A.M.S.)
- Correspondence: ; Tel.: +49-451-500-43952
| | - Max P. Brinkmann
- Laboratory for Angiogenesis & Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.B.); (J.A.M.S.)
| | - Jan A. M. Sochurek
- Laboratory for Angiogenesis & Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.B.); (J.A.M.S.)
| | - Michelle Prasuhn
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.); (S.G.); (M.R.)
- Laboratory for Angiogenesis & Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.B.); (J.A.M.S.)
| | - Salvatore Grisanti
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.); (S.G.); (M.R.)
| | - Mahdy Ranjbar
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.); (S.G.); (M.R.)
- Laboratory for Angiogenesis & Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany; (M.P.B.); (J.A.M.S.)
| |
Collapse
|
12
|
Heeman W, Steenbergen W, van Dam GM, Boerma EC. Clinical applications of laser speckle contrast imaging: a review. J Biomed Opt 2019; 24:1-11. [PMID: 31385481 PMCID: PMC6983474 DOI: 10.1117/1.jbo.24.8.080901] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [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: 04/15/2019] [Accepted: 07/02/2019] [Indexed: 05/02/2023]
Abstract
When a biological tissue is illuminated with coherent light, an interference pattern will be formed at the detector, the so-called speckle pattern. Laser speckle contrast imaging (LSCI) is a technique based on the dynamic change in this backscattered light as a result of interaction with red blood cells. It can be used to visualize perfusion in various tissues and, even though this technique has been extensively described in the literature, the actual clinical implementation lags behind. We provide an overview of LSCI as a tool to image tissue perfusion. We present a brief introduction to the theory, review clinical studies from various medical fields, and discuss current limitations impeding clinical acceptance.
Collapse
Affiliation(s)
- Wido Heeman
- University of Groningen, Faculty Campus Fryslân, Leeuwarden, The Netherlands
- University Medical Centre Groningen, Department of Surgery, Optical Molecular Imaging Groningen, Groningen, The Netherlands
- LIMIS Development BV, Leeuwarden, The Netherlands
| | - Wiendelt Steenbergen
- University of Twente, Techmed Center, Faculty of Science and Technology, Biomedical Photonic Imaging Group, Enschede, The Netherlands
| | - Gooitzen M. van Dam
- University Medical Centre Groningen, Department of Surgery, Optical Molecular Imaging Groningen, Groningen, The Netherlands
| | - E. Christiaan Boerma
- Medical Centre Leeuwarden, Department of Intensive Care, Leeuwarden, The Netherlands
- Address all correspondence to E. Christiaan Boerma, E-mail:
| |
Collapse
|
13
|
Higashiyama T, Ichiyama Y, Muraki S, Nishida Y, Ohji M. Optical Coherence Tomography Angiography in a Patient with Optic Atrophy After Non-arteritic Anterior Ischaemic Optic Neuropathy. Neuroophthalmology 2016; 40:146-149. [PMID: 27928400 DOI: 10.3109/01658107.2016.1162174] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/11/2016] [Accepted: 03/02/2016] [Indexed: 11/13/2022] Open
Abstract
A 75-year-old female noticed a lower visual field (VF) defect in the right eye. A diagnosis of non-arteritic anterior ischaemic optic neuropathy (NAION) was made. The lower VF defect in the right eye did not change after onset. Optical coherence tomography (OCT) angiograms on the disc and the macula showed decreased retinal perfusion in the upper retina of the right eye. Retinal nerve fibre layer loss and ganglion cell complex loss in the upper retina were also seen in the right eye. OCT angiography could non-invasively detect the decrease of the retinal perfusion due to NAION.
Collapse
Affiliation(s)
- Tomoaki Higashiyama
- Department of Ophthalmology, Shiga University of Medical Science , Shiga, Japan
| | - Yusuke Ichiyama
- Department of Ophthalmology, Shiga University of Medical Science , Shiga, Japan
| | - Sanae Muraki
- Department of Ophthalmology, Shiga University of Medical Science , Shiga, Japan
| | - Yasuhiro Nishida
- Clinical Medical Education Center, Shiga University of Medical Science , Shiga, Japan
| | - Masahito Ohji
- Department of Ophthalmology, Shiga University of Medical Science , Shiga, Japan
| |
Collapse
|
14
|
Watts MN, Eshaq RS, Carter PR, Harris NR. Decreased retinal blood flow in experimental colitis; improvement by eye drop administration of losartan. Exp Eye Res 2013; 115:22-6. [PMID: 23830910 DOI: 10.1016/j.exer.2013.06.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 04/04/2013] [Revised: 06/10/2013] [Accepted: 06/22/2013] [Indexed: 01/06/2023]
Abstract
Patients with inflammatory bowel disease suffer not only from gut inflammation, but also from extraintestinal manifestations of the disease, including ocular pathology. The mechanisms causing ocular inflammation in these patients are unknown. The purpose of the current study was to investigate the possible vascular changes occurring in the retina using a mouse model of acute colitis, that is, ingestion of dextran sodium sulfate (DSS). Intravital microscopy of anesthetized mice revealed that DSS caused a significant 30-40% decrease in retinal red blood cell velocities, and a 45% decrease in total retinal blood flow, but no changes in intraocular pressure. To determine whether the decreases in retinal perfusion could be inhibited by an angiotensin II receptor antagonist, losartan was administered by eye drops in a subset of the mice prior to the intravital microscopy measurements. Topical losartan was able to largely attenuate the altered hemodynamics induced by DSS. We conclude that angiotensin II might be a possible target for reducing the vascular changes occurring distantly in the eye during colitis.
Collapse
Affiliation(s)
- Megan N Watts
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA
| | | | | | | |
Collapse
|
15
|
Harris A, Ciulla TA, Pratt LM, Rechtman E, Kagemann L, Piper HC, Garzozi HJ. The effects of dorzolamide on choroidal and retinal perfusion in non-exudative age related macular degeneration. Br J Ophthalmol 2003; 87:753-7. [PMID: 12770975 PMCID: PMC1771708 DOI: 10.1136/bjo.87.6.753] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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] [Indexed: 11/04/2022]
Abstract
AIM To comprehensively evaluate the effects of dorzolamide on the choroidal and retinal circulation in patients with age related macular degeneration (AMD). METHODS In this randomised, double masked, parallel study, 36 non-exudative AMD patients were randomised in a 2 to 1 fashion to placebo versus topical dorzolamide and underwent assessment of their choroidal and retinal circulation. Scanning laser ophthalmoscope indocyanine green angiograms (ICGA) were analysed by a new area dilution analysis technique. Four areas in the perifoveal region and two areas in the temporal peripapillary region were evaluated by plotting intensity of fluorescence of each area over time. The means of the choroidal filling times and the heterogeneity of the filling times were assessed. Scanning laser ophthalmoscope fluorescein angiography (FA) was evaluated for retinal arteriovenous passage (AVP) times by plotting intensity of fluorescence of retinal vessels over time. Assessment was performed at baseline and at 4 months. RESULTS Compared to placebo, AMD patients treated with dorzolamide showed a significantly increased rapidity of choroidal filling in the superior and inferior peripapillary regions (p=0.007, p=0.02, respectively). No significant difference in choroidal filling times was found in any of the perifoveal areas (p=0.9). Also, on FA assessment, treatment with dorzolamide showed no statistical differences in AVP times (p=0.19). CONCLUSIONS Dorzolamide may increase peripapillary choroidal perfusion in non-exudative AMD patients. Further studies are merited.
Collapse
Affiliation(s)
- A Harris
- Department of Ophthalmology, Indiana University School of Medicine, IN 46260, USA.
| | | | | | | | | | | | | |
Collapse
|