Compensatory contribution of retinal larger vessels to perfusion density in diabetics without retinopathy

AbstractVessel and perfusion densities may decrease before diabetic retinopathy appears; it is unknown whether these changes affect the contribution of vessel density to perfusion density. This was a non-experimental, comparative, prospective, cross-sectional study in non-diabetic subjects (group 1) and diabetics without retinopathy (group 2). Vessel and perfusion densities in the superficial capillary plexus were compared between groups at the center, inner, and full regions and by field (superior, temporal, inferior, nasal) using optical coherence tomography angiography. Coefficients of determination (R2) between vessel and perfusion densities were calculated to find the contribution of larger retinal vessels to perfusion density. Percent differences were used to evaluate the contribution of these vessels to perfusion density in a regression model. There were 62 participants, 31 eyes by group; vessel and perfusion densities as well as the coefficients of determination between them were lower in group 2, especially in the nasal field (R2 0.85 vs. 0.71), which showed a higher contribution of larger retinal vessels to perfusion density. The regression model adjusted to a quadratic equation. In diabetics without retinopathy the contribution of vessel density to perfusion density may decrease; a low vessel density may increase the contribution of larger retinal vessels to perfusion density.

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Retinal vascular metrics difference by comparison of two image acquisition modes using a novel OCT angiography prototype

PLoS ONE ◽

10.1371/journal.pone.0243074 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243074

Author(s):

Luca Di Antonio ◽

Pasquale Viggiano ◽

Giada Ferro ◽

Lisa Toto ◽

Rossella D’Aloisio ◽

...

Keyword(s):

Healthy Subjects ◽

Image Acquisition ◽

Vessel Diameter ◽

Cross Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

En Face ◽

Capillary Plexus ◽

Perfusion Density ◽

Superficial Capillary Plexus

Purpose To assess the different impact of two enface OCTA image simultaneously acquired by means of a new prototype of Spectral-Domain Optical Coherence Tomography Angiography (SD-OCTA) on quantitative retinal vascular metrics. Methods In this prospective observational cross-sectional study 28 healthy subjects were enrolled. Macular (3x3 mm) OCTA images were acquired for all participants using Solix Fullrange OCT (Optovue Inc, Freemont CA, USA). The main outcome measurements were: Perfusion density (PD), vessel length density (VLD), and vessel diameter index (VDI) of both superficial capillary plexus (SCP) and deep capillary plexus (DCP), and choriocapillaris (CC) total flow-deficits area. Quantitative retinal vascular metrics were measured on binarized and skeletonized OCTA images by comparing not averaged and fast automated multiple averaged en face OCTA images. Results In both SCP and DCP, PD significantly increased (p = 0,005 and p = 0,030, respectively), and VLD significantly decreased (p<0,001 and p = 0,004, respectively), and VDI increased (p<0,001 and p = 0,068, respectively), and total CC flow deficits area significantly decreased (p<0,001) by averaging multiple OCTA images. Conclusions In this study, we found a significant difference of quantitative retinal metrics by comparing two different image acquisition modes using a novel and fully automated averaging OCTA system in young healthy subjects.

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Macular perfusion density evaluation in constant and intermittent exotropia by means of optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-021-02006-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jing Zhai ◽

Wei Fang ◽

Xueting Yu ◽

Xinjie Ye ◽

Lijie Hou

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Cross Sectional Study ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Intermittent Exotropia ◽

Cross Sectional ◽

Significant Difference ◽

Capillary Plexus ◽

Perfusion Density

Abstract Background To quantify and compare retinal microvascular features using optical coherence tomography angiography (OCTA) in constant (XT) and intermittent exotropia (IXT). Methods An observational cross-sectional study was conducted from September 2020 to November 2020 at the Affiliated Eye Hospital of Wenzhou Medical University. OCTA examination was performed to evaluate the macular perfusion density of the deep capillary plexus (DCP), superficial capillary plexus (SCP), and foveal avascular zone (FAZ) parameters in XT and IXT patients, and in age-matched controls. The study parameters were analyzed. Results A total of 76 participants, including 16 (21%) XT patients, 24 (32%) IXT patients, and 36 (47%) controls, were recruited. The exodeviation angle was 39.06 ± 10.38 prism degrees (PD) at near and 43.00 ± 9.74 PD at distance in the XT group, and 27.13 ± 18.28 PD at near and 31.04 ± 18.82 PD at distance in the IXT group. The macular perfusion density of the DCP in 6 × 6-mm scans and the SCP in 3 × 3-mm scans were lower in the deviating eyes than in the fixating eyes of XT patients (p < 0.001, p = 0.032, respectively). The macular perfusion density of the DCP in the deviating eyes of XT and IXT patients was significantly lower than that of the controls. There was no significant difference in the FAZ parameters among the groups. Conclusions In XT patients, OCTA revealed lower macular perfusion density in deviating eyes than in fixating eyes and control eyes. IXT patients showed no difference between the two eyes, but the macular perfusion density of the DCP was lower than that of the controls.

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Repeatability of Peripapillary Optical Coherence Tomography Angiography Parameters in Older Adults

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420953968 ◽

2020 ◽

pp. 247412642095396

Author(s):

Cason B. Robbins ◽

Dilraj S. Grewal ◽

Atalie C. Thompson ◽

Stephen P. Yoon ◽

Brenda L. Plassman ◽

...

Keyword(s):

Older Adults ◽

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Intraclass Correlation ◽

Cross Sectional Study ◽

Optical Coherence ◽

Capillary Perfusion ◽

Cross Sectional ◽

Capillary Plexus ◽

Perfusion Density

Purpose: This work assesses the intrasession repeatability of capillary perfusion density (CPD) and capillary flux index (CFI) measurements on peripapillary optical coherence tomography angiography (OCTA) in healthy eyes of older adults. Methods: In this cross-sectional study, healthy volunteers aged 50 years or older underwent 4.5 × 4.5 mm OCTA imaging centered on the optic nerve head using Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss Meditec). Two consecutive images were acquired in the same eye during a single study session. CPD and CFI were assessed using AngioPlex Software (version 11.0.0.29946) for the radial peripapillary capillary plexus (average over whole scan area) and 4 quadrants (superior, inferior, temporal, and nasal). CPD and CFI repeatability was assessed by intraclass correlation (ICC), mean interocular differences using 2-tailed t test, and association with age using generalized estimating equations. Results: A total of 150 images were acquired from 75 eyes of 47 patients. For CPD, ICC results ranged from 0.7160 (nasal CPD) to 0.9218 (average CPD). For CFI, ICC results ranged from 0.6167 (temporal CFI) to 0.8976 (inferior CFI). Temporal CFI was significantly different between right and left eyes of the same patient ( P = .03). CPD and CFI decreased with age in all analyses (average CPD β coefficient –0.00172, P < .001; average CFI β coefficient −0.00278, P < .001). Conclusions: Moderate to good repeatability was observed for most peripapillary OCTA metrics; temporal measurements were least repeatable for CPD and CFI. Peripapillary CPD and CFI decrease with age even beyond the fifth decade in healthy older adults.

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Quantitative Analysis of Foveal Microvascular Differences in Diabetic Macular Edema with and without Subfoveal Neuroretinal Detachment

Journal of Diabetes Research ◽

10.1155/2020/2582690 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Gao Jian ◽

Xu Ya Jing ◽

Li Yang ◽

Liu Lun

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Significant Negative Correlation ◽

Cross Sectional Study ◽

Vessel Density ◽

Foveal Avascular Zone ◽

Cross Sectional ◽

Avascular Zone ◽

Capillary Plexus ◽

The Difference

Purpose. This study is aimed at quantifying the difference of the foveal microvasculature in the eyes with diabetic macular edema (DME) with and without subfoveal neuroretinal detachment (SND+ and SND-, respectively). Methods. This retrospective, cross-sectional study included 48 eyes from 42 patients with DME (20 SND+ and 28 SND- eyes). Data collection included fundus color photographs, optical coherence tomography angiography (OCTA), and best-corrected visual acuity. The following parameters were evaluated with OCTA: foveal avascular zone (FAZ) parameters and vessel density in a width of 300 μm around the FAZ, superficial capillary plexus, deep capillary plexus (DCP), and choriocapillary plexus. The number of retinal hyperreflective spots (HRS) and the area of SND in the central 3 mm were evaluated at 0 degrees using B-scans. Results. Parafoveal vessel densities of DCP were significantly lower in SND+ than in SND- eyes (p<0.001). The number of HRS was significantly higher in SND+ than in SND- eyes (p<0.001). A statistically significant negative correlation between parafoveal vessel density in DCP and the number of HRS in all eyes was found (Spearman’s correlation, r=0.389, p=0.006). Conclusion. DME with SND correlated with larger numbers of HRS and significant macular microvascular impairment in the DCP. The pathophysiology of decline of parafoveal vessel density in the DCP with an increase in the number of HRS in the eyes with DME with SND needs further investigation.

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Diagnostic performance of OCT and OCTA in less than 60-year-old patients with early POAG: a cross-sectional study

International Journal of Ophthalmology ◽

10.18240/ijo.2020.12.11 ◽

2020 ◽

Vol 13 (12) ◽

pp. 1915-1921

Author(s):

Yan-Jie Li ◽

Zi-Chao Bai ◽

Rong-Xia Cao ◽

Hai-Hua Ren

Keyword(s):

Optic Disc ◽

Cross Sectional Study ◽

Vessel Density ◽

Diagnostic Utility ◽

Macular Area ◽

Cross Sectional ◽

Old Patients ◽

Disc Area ◽

Best Parameter ◽

Perfusion Density

AIM: To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma (POAG) by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and to evaluate the diagnostic value of OCT and OCTA. METHODS: Totally 15 patients (23 eyes) with early POAG as observation group and 30 health people (30 eyes) as normal control group were enrolled in this cross-sectional study. OCTA-based superficial macula vessel density, superficial macula perfusion density, superficial optic disc vessel density, superficial optic disc perfusion density and spectral domain OCT (SD-OCT)-based macular area thickness, ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness were measured in the two groups. Independent t-test and receiver operating characteristic curve were used for analysis. Area under the receiver operating characteristic curves (AUROC) were used to measure the diagnostic utility. RESULTS: Among all the parameters, the optimal diagnostic utility parameter was the superficial vessel density in the macular area (except the center of the macula), and the AUROC reached 0.98. The diagnostic utility of macular area perfusion density (except the center of the macula) was similar to that of superficial vessel density in the macular area, and the AUROC was above 0.97. Followed by the diagnostic utility of vessel density in the optic disc area, the best parameter was the inner ring of the vessel density, and its AUROC reached 0.97. The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area. The best parameter was the central optic disc perfusion density, and its AUROC was 0.95. The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above, the top three parameters were the inferior RNFL thickness (AUROC=0.919), the superior (AUROC=0.919) and the inferior GCC thickness (AUROC=0.9077). CONCLUSION: The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters. OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.

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The Role of OCT Angiography in the Assessment of Epiretinal Macular Membrane

Journal of Ophthalmology ◽

10.1155/2021/8866407 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Daniela Bacherini ◽

Francesco Dragotto ◽

Tomaso Caporossi ◽

Chiara Lenzetti ◽

Lucia Finocchio ◽

...

Keyword(s):

Visual Acuity ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Vascular Changes ◽

Capillary Plexus ◽

Area And Perimeter ◽

Perfusion Density ◽

Superficial Capillary Plexus

Background. The aim of this observational study is to assess pre- and postoperative retinochoroidal vascular changes in patients undergoing epiretinal macular membrane (ERM) surgery by using optical coherence tomography angiography (OCTA). Materials and Methods. 23 eyes affected by ERM and those which underwent phacovitrectomy associated with ERM peeling were enrolled. They were evaluated using structural OCT and OCTA before surgery and at 1, 3, and 6 months postoperatively. Results. We found a statistically significant ( p < 0.05) increase in the superficial capillary plexus vessel density (VD) from baseline to the 6-month follow-up. We observed a large increase in both the perfusion density (PD) and the VD of the deep capillary plexus between baseline and the 6-month follow-up ( p < 0.001). A significant decrease in the VD and PD of the choriocapillaris (CC) from baseline to the 1st month and a significant increase in CC perfusion density at the 6-month follow-up compared to the preoperative value were revealed. The FAZ area and perimeter after surgery significantly increased during the follow-up ( p < 0.001) at baseline retinal and choroidal plexi with a lower PD or VD correlated with worse visual acuity ( p < 0.05 for all plexi). At baseline and at the 1-month follow-up, a significant correlation was found with the FAZ area and the FAZ perimeter: a smaller FAZ area or a smaller FAZ perimeter was correlated to a lower visual acuity. Before surgery, negative correlations ( p < 0.05) were found between the Govetto ERM stages and perfusion density of the SCP and the DCP and between the Govetto stages and vessel density of the DCP. Conclusions. In our study, OCTA detected vascular alterations induced by the presence of the ERM, allowing several correlations with functional data. In these patients, OCTA may be useful to add new potential surgical prognostic factors.

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The diagnostic performance of optical coherence tomography and optical coherence tomography angiography for early primary open-angle glaucoma: a cross-sectional study

10.21203/rs.2.15959/v1 ◽

2019 ◽

Author(s):

Yanjie Li ◽

Weishai Liu ◽

Zichao Bai ◽

Rongxia Cao ◽

Haihua Ren

Keyword(s):

Optical Coherence Tomography ◽

Optic Disc ◽

Operating Characteristic ◽

Open Angle Glaucoma ◽

Cross Sectional Study ◽

Vessel Density ◽

Diagnostic Utility ◽

Optical Coherence ◽

Cross Sectional ◽

Perfusion Density

Abstract Background: Primary open angle glaucoma (POAG) is often delayed in diagnosis and treatment, as it has no acute attack period, and symptoms usually appear at a relatively late stage. Optical coherence tomography angiography (OCTA) on the basis of Carl Zeiss optical coherence tomography with the support of FOURM platform is recently available in China. It is reportedly more sensitive to POAG. We reported the diagnostic utilities of OCTA and OCT which is already in clinical practice. Methods: 15 patients (23 eyes) with early POAG as observation group and 30 health people (30 eyes) as normal control group were enrolled in this cross-sectional study. OCTA-based superficial macula vessel density, superficial macula perfusion density, superficial optic disc vessel density, superficial optic disc perfusion density and OCT-based macula thickness, ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness were recorded in the two groups. Independent sample t-test and receiver operating characteristic curve were used for statistical analysis. Area under the receiver operating characteristic curves (AUCs) were used to measure the diagnostic utility.Results: The optimal diagnostic utility parameters were the superficial vessel density and perfusion density in the macula (except the center of macula), and the AUCs were above 0.97. Followed by the superficial vessel density and perfusion density in the optic disc area. The OCT-based diagnostic utility parameters were generally lower than that mentioned above, the top three parameters were the inferior RNFL thickness (AUC=0.919), the superior GCC thickness (AUC=0.919) and the inferior GCC thickness (AUC = 0.908).Conclusions: Changes of thickness in macula, GCC, RNFL, and changes of superficial vessel density and perfusion density in the optic disc or in macula can be detected by OCT or by OCTA in early POAG. The OCTA-based diagnostic utility was generally higher than the OCT-based diagnostic utility.

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Effect of axial length on peripapillary microvasculature: An optical coherence tomography angiography study

PLoS ONE ◽

10.1371/journal.pone.0258479 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258479

Author(s):

Kee Sup Park ◽

Hyung Bin Lim ◽

Yong Il Shin ◽

Gi Seok Park ◽

Woo Hyuk Lee ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Axial Length ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Capillary Plexus ◽

Group 3 ◽

Group 2 ◽

Perfusion Density ◽

Superficial Capillary Plexus ◽

Group 1

Objective To investigate the effects of axial length (AL) on the peripapillary microvascular density acquired from optical coherence tomography angiography (OCTA). Methods Retrospective observational study. A total of 111 eyes from 111 normal healthy subjects were examined. The subjects were divided into three groups according to the AL: Group 1 (AL: < 24.0 mm; 35 eyes), Group 2 (AL: 24.0–25.99 mm; 37 eyes), and Group 3 (AL: ≥ 26 mm; 39 eyes). Peripapillary OCTA images were acquired using 6× 6 mm angiography scans, and vessel density (VD) and perfusion density (PD) of the superficial capillary plexus were calculated automatically. VD and PD were compared among the three groups according to the distance from the optic disc (inner and outer rings). Linear regression analyses were also performed to identify clinical factors associated with average VD. Results The average ALs of Groups 1–3 were 23.33± 0.57, 25.05± 0.60, and 27.42± 0.82, respectively. Average VD (P = 0.009) and PD (P = 0.029) in the inner ring increased with increasing AL. However, average VD (P < 0.001) and PD (P < 0.001) in the outer ring decreased with AL increased; the same trends were found for the full areas (VD, p<0.001; PD, p = 0.001). Average VDs in the inner and outer rings were not associated (P = 0.938). Conclusions Peripapillary VD and PD were significantly associated with AL. Depending on the distance from the disc, peripapillary VDs and PDs of the inner and outer rings were differentially affected by AL. Physicians should therefore consider the effects of AL in the analyses of peripapillary microvasculature.

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Effect of the Cut-Off Level for Thyroid-Stimulating Hormone on the Prevalence of Subclinical Hypothyroidism among Infertile Mexican Women

Diagnostics ◽

10.3390/diagnostics11030417 ◽

2021 ◽

Vol 11 (3) ◽

pp. 417

Author(s):

Lidia Arce-Sánchez ◽

Salvatore Giovanni Vitale ◽

Claudia Montserrat Flores-Robles ◽

Myrna Souraye Godines-Enriquez ◽

Marco Noventa ◽

...

Keyword(s):

Insulin Resistance ◽

Subclinical Hypothyroidism ◽

Thyroid Autoimmunity ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Mexican Women ◽

Cross Sectional ◽

Group 3 ◽

Group 2 ◽

Group 1

The primary aim of this study was to compare the prevalence of subclinical hypothyroidism (SCH) using two different cut-off levels for TSH values (≥2.5 mIU/L versus ≥4.1 mIU/L). The secondary objective was to analyze the clinical-biochemical characteristics in women with and without SCH. This was a retrospective cross-sectional study. In total, 1496 Mexican women with infertility were included: Group 1, women with TSH levels ranging between 0.3 and 2.49 mIU/L, n = 886; Group 2, women with TSH between 2.5 and 4.09 mIU/L, n = 390; and Group 3, women with TSH ≥4.1 mIU/L n = 220. SCH prevalence was 40.7% (CI 95%: 38.3–43.3%) with TSH cut-off ≥ 2.5 mIU/L, and 14.7% (CI 95%: 12.7–16.5%) with TSH cut-off ≥ 4.1 mIU/L, (p = 0.0001). The prevalence of overweight was higher in Group 2 than in Groups 1 and 3. Thyroid autoimmunity, obesity and insulin resistance were higher in Group 3 than in Group 1 (p < 0.05). No other differences were observed between groups. Conclusions: The prevalence of SCH in our selected patients increased almost three times using a TSH cut-off ≥ 2.5 mIU/L compared with a TSH cut-off ≥ 4.1 mIU/L. Women with TSH ≥4.1 mIU/L compared with TSH cut-off ≤ 2.5 mIU/L more often presented with obesity, thyroid autoimmunity and insulin resistance.

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The correlation between uremic pruritus and blood lead levels in prevalent hemodialysis patients and its relation to the severity of pruritus using visual analog score

The Egyptian Journal of Internal Medicine ◽

10.1186/s43162-021-00045-0 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Sahar Mahmoud Shawky ◽

Reeham Abdel Aziz Abdel Hamid ◽

Lina Essam Khedr

Keyword(s):

Blood Lead ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Visual Analog Score ◽

Blood Lead Levels ◽

Cross Sectional ◽

Uremic Pruritus ◽

Significant Difference ◽

Lead Levels ◽

Group 2

Abstract Background Pruritus is a common and often distressing symptom in patients with chronic kidney disease. Though the pathogenesis of uremic pruritus remains poorly understood, systemic inflammation has presented itself as one of the possible explanations. High blood lead levels (BLLs) have been noted to be associated with inflammation and poor nutritional status in hemodialysis patients. Our aim is to study the relation between blood lead levels and uremic pruritus. This is a cross-sectional study that enrolled 50 patients; all were on regular hemodialysis 3 times per week for at least 6 months. Patients were divided into 2 groups, group 1 (n =10) with no pruritus and group 2 (n=40) with varying degrees of pruritus. Group 2 was further divided according to intensity of pruritus by visual analog score (VAS) into mild (n=10), moderate (n=20), and severe pruritus (n=10). Results There was a significant difference in serum lead levels and ferritin levels between groups 1 and 2 (p value < 0.01 and < 0.05, respectively). There was a statistically significant difference in serum lead levels in the groups with varying intensity of pruritus, having higher serum lead levels in patients who exhibited severe pruritus (p value < 0.005) Moreover, a statistically significant relation between elevated blood lead levels and the duration of dialysis was observed in this study. Conclusion Uremic pruritus is a multi-factorial phenomenon, and our study showed that blood lead levels in hemodialysis patients might be associated with increased intensity of pruritus.

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