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Ding X, Shu Q, Bai X, Chang Q, Xu G, Chen L. The Role of Widefield Optical Coherence Tomography Angiography in the Diagnosis and Management of Acute Vogt-Koyanagi-Harada Disease. Ocul Immunol Inflamm 2024; 32:391-401. [PMID: 36856749 DOI: 10.1080/09273948.2023.2181186] [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: 09/20/2021] [Accepted: 02/11/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE We explore the choroid vasculature changes of acute Vogt-Koyanagi-Harada (VKH) disease using widefield optical coherence tomography angiography (OCTA). METHODS In this retrospective, observational, longitudinal study, 16 patients with acute VKH disease (32 eyes, mean age: 42.19 ±13.66 years) were measured using widefield OCTA. RESULTS In this study, we first described the multiple dark foci in choriocapillaris and Sattler's layer in the panoramic montage of the five 12x12mm images in 30 eyes (93.8%) of acute VKH disease. OCTA follow-up in these 30 eyes demonstrated the diminished size and number of these dark foci in choriocapillaris and Sattler's layer after the initiation of treatment. CONCLUSIONS Widefield OCTA enables noninvasive identification of characteristics of flow void at the level of superficial choroidal vessels in the acute phase and may be a novel valuable tool for diagnosis and monitoring of disease progression in VKH disease in the future.
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Affiliation(s)
- Xinyi Ding
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration and Key Laboratory of Myopia, Ministry of Health, Hanoi, Vietnam
| | - Qinmeng Shu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration and Key Laboratory of Myopia, Ministry of Health, Hanoi, Vietnam
| | - Xinyue Bai
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration and Key Laboratory of Myopia, Ministry of Health, Hanoi, Vietnam
| | - Qing Chang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration and Key Laboratory of Myopia, Ministry of Health, Hanoi, Vietnam
| | - Gezhi Xu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration and Key Laboratory of Myopia, Ministry of Health, Hanoi, Vietnam
| | - Ling Chen
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration and Key Laboratory of Myopia, Ministry of Health, Hanoi, Vietnam
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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.
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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
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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.
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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.
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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.)
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Rommel F, Siegfried F, Sochurek JAM, Rothe M, Brinkmann MP, Kurz M, Prasuhn M, Grisanti S, Ranjbar M. Mapping diurnal variations in choroidal sublayer perfusion in patients with idiopathic epiretinal membrane: an optical coherence tomography angiography study. Int J Retina Vitreous 2019; 5:12. [PMID: 31139433 PMCID: PMC6528351 DOI: 10.1186/s40942-019-0162-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 12/28/2018] [Accepted: 03/29/2019] [Indexed: 04/26/2023] Open
Abstract
Background Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the choroidal vasculature and perfusion state. In this index study, OCTA was used to investigate diurnal changes in choroidal sublayer perfusion in eyes with idiopathic epiretinal membrane (ERM) and to identify impacting factors. Methods A prospective study was conducted on volunteers with symptomatic ERM, each of whom underwent repeated measurements of subfoveal choroidal thickness (SFCT) using enhanced-depth imaging optical coherence tomography and perfusion of choroidal vascular sublayers using OCTA at 7 a.m., 12 p.m., 4 p.m., and 8 p.m. Possible interactions between diurnal variations and other factors, such as gender and age, were evaluated. Results A total of 21 eyes of 21 participants (mean age 72.43 ± 7.06 years) were analysed. A significant pattern of diurnal variation was observed for SFCT (p = 0.008) as well as perfusion of Haller's layer (HLP, p = 0.001). SFCT and HLP both demonstrated a quadratic relation to time of the day, decreasing from morning to afternoon, before increasing again in the evening. No significant differences with regard to gender or age were detectable. Conclusion OCTA-based analysis of choroidal sublayer perfusion demonstrated significant diurnal variations in patients with symptomatic ERM, which are quite different from changes reported in healthy eyes. Therefore, it is important to account for time of day, when comparing longitudinal OCTA data.
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Affiliation(s)
- Felix Rommel
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany.,Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Fynn Siegfried
- Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Jan A M Sochurek
- Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Matthias Rothe
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany.,Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Max P Brinkmann
- Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Maximilian Kurz
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany.,Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Michelle Prasuhn
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany.,Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Salvatore Grisanti
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Mahdy Ranjbar
- Department of Ophthalmology, Ratzeburger Allee 160, 23538 Lübeck, Germany.,Laboratory for Angiogenesis and Ocular Cell Transplantation, Ratzeburger Allee 160, 23538 Lübeck, Germany
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