scholarly journals The effect of systemic factors on retinal blood flow in patients with carotid stenosis: an optical coherence tomography angiography study

GeroScience ◽  
2021 ◽  
Author(s):  
Lilla István ◽  
Cecilia Czakó ◽  
Fruzsina Benyó ◽  
Ágnes Élő ◽  
Zsuzsa Mihály ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Optical Coherence Tomography ◽  
Carotid Artery ◽  
Systemic Risk ◽  
Carotid Artery Stenosis ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Blood Flow ◽  
Systemic Factors ◽  
Systemic Risk Factors

AbstractCarotid artery stenosis (CAS) is among the leading causes of mortality and permanent disabilities in the Western world. CAS is a consequence of systemic atherosclerotic disease affecting the majority of the aging population. Optical coherence tomography angiography (OCTA) is a novel imaging technique for visualizing retinal blood flow. It is a noninvasive, fast method for qualitative and quantitative assessment of the microcirculation. Cerebral and retinal circulation share similar anatomy, physiology, and embryology; thus, retinal microvasculature provides a unique opportunity to study the pathogenesis of cerebral small vessel disease in vivo. In this study, we aimed to analyze the effect of systemic risk factors on retinal blood flow in the eyes of patients with significant carotid artery stenosis using OCT angiography. A total of 112 eyes of 56 patients with significant carotid stenosis were included in the study. We found that several systemic factors, such as decreased estimated glomerular filtration rate (eGFR), hypertension, and carotid occlusion have a significant negative effect on retinal blood flow, while statin use and carotid surgery substantially improve ocular microcirculation. Neither diabetes, clopidogrel or acetylsalicylic acid use, BMI, serum lipid level, nor thrombocyte count showed a significant effect on ocular blood flow. Our results demonstrate that a systematic connection does exist between certain systemic risk factors and retinal blood flow in this patient population. OCTA could help in the assessment of cerebral circulation of patients with CAS due to its ability to detect subtle changes in retinal microcirculation that is considered to represent changes in intracranial blood flow.

scholarly journals Association Between the Severity of Diabetic Retinopathy and Optical Coherence Tomography Angiography Metrics

2021 ◽  
Vol 12 ◽  
Author(s):  
Binxin Xu ◽  
Jiahui Chen ◽  
Shaohua Zhang ◽  
Shengli Shen ◽  
Xuan Lan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Systemic Risk ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Segmentation ◽  
Optical Coherence ◽  
Segmentation Method ◽  
The Relationship ◽  
Systemic Risk Factors

Diabetic retinopathy, the most serious ocular complication of diabetes, imposes a serious economic burden on society. Automatic and objective assessment of vessel changes can effectively manage diabetic retinopathy and prevent blindness. Optical coherence tomography angiography (OCTA) metrics have been confirmed to be used to assess vessel changes. The accuracy and reliability of OCTA metrics are restricted by vessel segmentation methods. In this study, a multi-branch retinal vessel segmentation method is proposed, which is comparable to the segmentation results obtained from the manual segmentation, effectively extracting vessels in low contrast areas and improving the integrity of the extracted vessels. OCTA metrics based on the proposed segmentation method were validated to be reliable for further analysis of the relationship between OCTA metrics and diabetes and the severity of diabetic retinopathy. Changes in vessel morphology are influenced by systemic risk factors. However, there is a lack of analysis of the relationship between OCTA metrics and systemic risk factors. We conducted a cross-sectional study that included 362 eyes of 221 diabetic patients and 1,151 eyes of 587 healthy people. Eight systemic risk factors were confirmed to be closely related to diabetes. After controlling these systemic risk factors, significant OCTA metrics (such as vessel complexity index, vessel diameter index, and mean thickness of retinal nerve fiber layer centered in the macular) were found to be related to diabetic retinopathy and severe diabetic retinopathy. This study provides evidence to support the potential value of OCTA metrics as biomarkers of diabetic retinopathy.

scholarly journals Quantitative Optical Coherence Tomography Angiography Detects Retinal Perfusion Changes in Carotid Artery Stenosis

2021 ◽  
Vol 15 ◽  
Author(s):  
Luisa Pierro ◽  
Alessandro Arrigo ◽  
Michele De Crescenzo ◽  
Emanuela Aragona ◽  
Roberto Chiesa ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Optical Coherence Tomography Angiography ◽  
Artery Stenosis ◽  
Ocular Involvement ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Vascular Perfusion ◽  
Before And After

BackgroundCarotid artery stenosis (CAS) is a multifaceted disease characterized by possible ocular involvement. Treatment with carotid endarterectomy helps to restore cerebral perfusion, which may prevent ocular and cerebral complications. The main aim was to assess retinal and choroidal vascular perfusion changes before and after endarterectomy in patients affected by CAS.MethodsThe design of the study was prospective and observational, including patients affected by CAS and healthy controls. The follow-up was 3 months. We performed quantitative optical coherence tomography (OCT) angiography (OCTA) analyses of retinal perfusion changes, before and after endarterectomy. The main outcome measures were the quantitative changes of choroidal thickness (CT), retinal nerve fiber layer (RNFL), and ganglion cell layer (GCL); vessel density (VD); and vessel tortuosity (VT) OCTA metrics were also measured.ResultsSixty eyes of 30 patients affected by CAS and 30 eyes of 30 controls were included. We separately considered the ipsilateral eyes to CAS, the contralateral eyes to CAS, and the healthy eyes. Visual symptoms were absent in all the patients. RNFL and GCL resulted similar between patients and controls (p > 0.05). CT was significantly thinner in ipsilateral eyes than controls (p < 0.01), and it resulted unchanged after surgery (p > 0.05). VD resulted significantly altered only in some plexa of the ipsilateral eyes (p < 0.01), whereas VT disclosed decreased values of the entire retinal vascular network, both in ipsilateral and contralateral eyes (p < 0.05). Endarterectomy was followed by statistically significant improvement of retinal perfusion (p < 0.05).ConclusionOptical coherence tomography angiography can noninvasively detect postendarterectomy retinal perfusion improvements in CAS patients with baseline diabetes and hypertension as a systemic risk factor.

scholarly journals Optical Coherence Tomography Angiography to Estimate Retinal Blood Flow in Eyes with Retinitis Pigmentosa

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Masako Sugahara ◽  
Manabu Miyata ◽  
Kenji Ishihara ◽  
Norimoto Gotoh ◽  
Satoshi Morooka ◽  
...  
Keyword(s):  
Blood Flow ◽  
Optical Coherence Tomography ◽  
Retinitis Pigmentosa ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Blood Flow ◽  
Optical Coherence
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