Optical coherence tomography angiography retinal vascular network assessment in multiple sclerosis

Background: Optical coherence tomography (OCT) angiography is a new method to assess the density of the vascular networks. Vascular abnormalities are considered involved in multiple sclerosis (MS) pathology. Objective: To assess the presence of vascular abnormalities in MS and to evaluate their correlation to disease features. Methods: A total of 50 MS patients with and without history of optic neuritis (ON) and 46 healthy subjects were included. All underwent spectral domain (SD)-OCT and OCT angiography. Clinical history, Expanded Disability Status Scale (EDSS), Multiple Sclerosis Severity Score (MSSS) and disease duration were collected. Results: Angio-OCT showed a vessel density reduction in eyes of MS patients when compared to controls. A statistically significant reduction in all SD-OCT and OCT angiography parameters was noticed both in eyes with and without ON when compared with control eyes. We found an inverse correlation between SD-OCT parameters and MSSS ( p = 0.003) and between vessel density parameters and EDSS ( p = 0.007). Conclusion: We report a vessel density reduction in retina of MS patients. We highlight the clinical correlation between vessel density and EDSS, suggesting that angio-OCT could be a good marker of disease and of disability in MS.

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Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study

PLoS ONE ◽

10.1371/journal.pone.0253417 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253417

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Ganglion Cell ◽

Neuromyelitis Optica ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectrum Disorder ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder ◽

Capillary Plexus

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS+ON and MS-ON eyes compared to healthy eyes. In NMOSD+ON and NMOSD-ON, the DCP did not remarkably differ from the control group. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS+ON, MS-ON, and NMOSD+ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to ganglion cells’ atrophy, while vasculopathy seems to be a primary process in NMOSD patients.

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Оptical coherence tomography and optical coherence tomography-angiography in determining the progression of glaucoma

POINT OF VIEW EAST – WEST ◽

10.25276/2410-1257-2021-1-26-31 ◽

2021 ◽

pp. 26-31

Author(s):

N.I. Kurysheva ◽

◽

A.D. Nikitina ◽

Keyword(s):

Optical Coherence Tomography ◽

Functional Assessment ◽

Oct Angiography ◽

Ganglion Cell Complex ◽

Automated Perimetry ◽

Optical Coherence ◽

Complex Dynamic ◽

Glaucoma Progression ◽

Primary Glaucoma ◽

Sd Oct

Purpose. To study the role of optical coherence tomography (OCT) and OCT angiography (OCTA) in the detection of the primary glaucoma progression. Material and methods. The prospective study of 128 patients with primary glaucoma (128 eyes), conducted from 2015 to 2019, included at least 6 standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT) examinations in each patient; OCTA was also used during the last year of observation. To determine the disease progression, the trend and event analysis using the Humphrey Field Analyzer was performed. The fact and rate of thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated. If they had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The values of corneal-compensated IOP were also considered: minimal (IOPmin) and peak (IOPmax). Results. Glaucoma progression was detected in 79 eyes. The isolated use of SAP allows detecting the progression only in 2.3% cases, SD-OCT - in 37.5%, among them the isolated assessment of GCC amounted to 7.8%, and RNFL – to 5.5%. The complex dynamic morphological and functional assessment increased the possibility of progression detection up to 61.7%. Progression was related to the stage of glaucoma damage at the moment of diagnosis: for the perimetry index PSD p=0.025, for the focal loss volume of GCC p=0.024, as well as with the level of minimal IOP (p=0.04). All patients with progression have shown the vessel density decrease in the peripapillary retina and parafovea. Conclusion. SD-OCT plays an important role in detecting the progression of glaucoma. The complex dynamic morphological and functional assessment allows detecting the progression in over half of patients. Progression is associated with the initial stage of glaucoma and an insufficient IOP decrease during treatment, accompanied by retinal microcirculation deterioration. Key words: primary, glaucoma progression, optical coherence tomography, OCT-angiography, IOP.

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Deep Capillary Macular Perfusion Indices Obtained with OCT Angiography Correlate with Degree of Nonproliferative Diabetic Retinopathy

European Journal of Ophthalmology ◽

10.5301/ejo.5000948 ◽

2017 ◽

Vol 27 (6) ◽

pp. 716-729 ◽

Cited By ~ 28

Author(s):

Kumar Sambhav ◽

Khaled K. Abu-Amero ◽

Kakarla V. Chalam

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Inverse Correlation ◽

Normal Subjects ◽

Vessel Density ◽

Perfusion Index ◽

Flow Index ◽

Optical Coherence ◽

Nonproliferative Diabetic Retinopathy

Purpose To evaluate the integrity of macular and temporomacular vasculature in nonproliferative diabetic retinopathy (NPDR) with noninvasive optical coherence tomography angiography (OCTA) and correlate perfusion indices with degree of NPDR. Methods In this prospective observational cross-sectional study, 102 eyes with newly diagnosed NPDR (mild NPDR, 36; moderate NPDR, 21; severe NPDR, 13; NPDR with diabetic macular edema [DME], 32) underwent OCTA. Sixty eyes of normal subjects served as control. Degree of NPDR (based on Early Treatment Diabetic Retinopathy Study criteria) was confirmed with fluorescein angiography. Automated OCTA/split-spectrum amplitude decorrelation angiography software generated perfusion indices (vessel density and flow index) from images of the retina. The perfusion index of superficial and deep retinal plexuses was obtained in both perifoveal (central 1-3 mm) and parafoveal (3-6 mm) areas. Results Deep plexus parafoveal vessel density was 25.23% (±6.1) in mild NPDR, 20.16% (±6.16) in moderate NPDR, 11.16% (±4.16) in severe NPDR, and 17.91% (±4.42) in NPDR + DME compared to normal subjects (36.93% [±8.1]; (p<0.01). Spearman correlation coefficient (rs) between vessel density and level of NPDR severity in the parafoveal region showed inverse correlation for both superficial (rs -0.87; p = 0.083) and deep (rs -0.96; p = 0.017) plexus. Similarly, when vessel density of the perifoveal region was compared with level of NPDR severity, inverse correlation was noted in both superficial (rs -0.85; p = 0.08) and deep (rs -0.98; p = 0.011) plexus. Conclusions Optical coherence tomography angiography clearly delineated the retinal microcirculation and allowed quantification of vascular perfusion of each layer. As diabetic retinopathy progressed, a decrease in perfusion index is more pronounced in the deep retinal plexus and precedes changes in superficial plexus.

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Peripapillary and Macular Flow Changes in Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) by Optical Coherence Tomography Angiography (OCT-A)

Journal of Ophthalmology ◽

10.1155/2020/3010631 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Zuohuizi Yi ◽

Hongmei Zheng

Keyword(s):

Optical Coherence Tomography ◽

Optic Neuropathy ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Optical Coherence ◽

Significant Difference ◽

Flow Changes ◽

Sd Oct

Background. To analyze the blood flow changes of radial peripapillary capillaries (RPCs) and macula with time procession in patients with nonarteritic anterior ischemic optic neuropathy (NAION) by optical coherence tomography angiography (OCT-A). Methods. A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3–6 months after enrollment. Measures of the thickness of the peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of the RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed. Results. Compared to unaffected control eyes, wRPC ( p ≤ 0.001 ) was significantly lower in affected eyes at baseline, and there was no significant difference in wSVD ( p > 0.05 ). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1–2 and 3–6 months compared to baseline ( p = 0.001 , p ≤ 0.001 ; p ≤ 0.001 , p ≤ 0.001 ). The sRPC values were significantly lower than iRPC at 1-2/3–6 months ( p = 0.016 , p = 0.013 ), and sSVD values were lower than iSVD at 1-2 months ( p = 0.010 ). Statistically significant correlations were found between wRPC and wRNFL values at 3–6 months (r = 0.626, p = 0.022 ), between wSVD and wGCC at 1-2 weeks and 1-2 months (r = 0.570, r = 0.436; p = 0.007 , p = 0.048 ). Conclusion. OCT-A revealed a sectorial reduction in vessel density in the RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

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Reproducibility of high-resolution optical coherence tomography in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458510371640 ◽

2010 ◽

Vol 16 (7) ◽

pp. 829-839 ◽

Cited By ~ 57

Author(s):

Stephanie B Syc ◽

Christina V Warner ◽

Girish S Hiremath ◽

Sheena K Farrell ◽

John N Ratchford ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Intraclass Correlation ◽

Healthy Controls ◽

Optical Coherence ◽

High Definition ◽

Fiber Layer ◽

Multiple Sclerosis Patients ◽

A Prospective Study ◽

Sd Oct

Optical coherence tomography (OCT) is a non-invasive method to quantify neurodegeneration as an outcome in multiple sclerosis clinical trials; however, no data exist on Cirrus spectral domain optical coherence tomography (SD-OCT) reproducibility in patients with multiple sclerosis. The objective of this study was to determine the protocol for achieving optimal inter-visit, inter-rater, and intra-rater reproducibility for studies performed on healthy controls and multiple sclerosis patients utilizing novel high-definition SD-OCT. This is a prospective study of inter-visit, inter-rater, and intra-rater reproducibility in multiple sclerosis patients ( n = 58) and healthy controls ( n = 32) on Cirrus-HD SD-OCT. Excellent reproducibility of average and quadrantic retinal nerve fiber layer (RNFL) thickness values, average macular thickness (AMT), and total macular volume (TMV) [measured by intraclass correlation coefficient (ICC)] was found for inter-visit (healthy controls: mean RNFL = 0.97, quadrant range = 0.92—0.97, AMT = 0.97, TMV = 0.92), inter-rater (MS: mean RNFL = 0.97, quadrant = 0.94—0.98, AMT = 0.99, TMV = 0.96; healthy controls: mean RNFL = 0.97, quadrant = 0.94—0.97, AMT = 0.98, TMV = 0.99), and intra-rater (MS patients: mean RNFL = 0.99, quadrant = 0.83—0.99, AMT = 0.97, TMV = 0.98) reproducibility. The reproducibility of retinal measures derived by Cirrus HD-OCT, especially quadrantic values, is excellent. Specific procedures for OCT acquisition and analysis of retinal imaging metrics using SD-OCT technology may improve the application of this novel technology in multiple sclerosis.

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Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study

Journal of Clinical Medicine ◽

10.3390/jcm10040609 ◽

2021 ◽

Vol 10 (4) ◽

pp. 609

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Spectrum Disorder ◽

Control Group ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary (RPC) vessel density in MS and NMOSD patients using optical coherence tomography angiography (OCTA). A total of 40 MS patients, 13 NMOSD patients, and 20 controls were included. The average RPC vessel density was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS−ON, NMOSD−ON) and in MS+ON, MS−ON, NMOSD+ON, and NMOSD−ON compared with the control group. In NMOSD+ON eyes, the vessel density in superior nasal, nasal superior, and inferior sectors was significantly more decreased than in MS+ON eyes. RPC reduction was also observed in inferior nasal and temporal superior sectors in MS−ON eyes compared with NMOSD−ON eyes. In conclusion, our findings indicate that optic neuritis is associated with a more significant RPC vessel density drop in NMOSD than in MS patients, and the predilection to superior and inferior sectors may be useful as a differential diagnostic marker.

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Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography angiography

10.21203/rs.2.20693/v1 ◽

2020 ◽

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Li Lu ◽

Zuohuizi Yi ◽

Hongmei Zheng

Keyword(s):

Optical Coherence Tomography ◽

Optic Neuropathy ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Anterior Ischemic Optic Neuropathy ◽

Ischemic Optic Neuropathy ◽

Optical Coherence ◽

Significant Difference ◽

Sd Oct

Abstract Background To analyze the blood flow changes of radial peripapillary capillaries (RPC) and macula with time procession in patients with non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCT-A).Methods A total of 21 affected eyes and 19 unaffected eyes from 21 NAION patients, and 40 eyes of 20 healthy individuals were included. Assessments of BCVA, CFP, SD-OCT, and OCT-A were performed on NAION patients at enrollment and at 1-2 weeks, 1-2 months, and 3-6 months post-enrollment. Measures of the thickness of peripapillary retinal nerve fiber layer (wRNFL) and macular ganglion cell complex (wGCC) of the whole image in SD-OCT, vessel density of RPC (wRPC) and superficial and deep vascular complexes (wSVD, wDVD) in the whole image of OCT-A, and their superior- and inferior-hemi values (s/iRNFL, s/iGCC, s/iRPC, and s/iSVD) were assessed.Results Compared to healthy controls, wRPC (p<0.001) and wDVD (P=0.001) were significantly lower in affected eyes at baseline, and there was no significant difference in wSVD (p>0.05). The wRPC and wSVD values of affected eyes were significantly decreased at follow-up time points of 1-2 and 3-6 months compared to baseline (p=0.001, p=0.000; p=0.000, p=0.000). The sRPC values were significantly lower than iRPC at 1-2/3-6 months (p=0.001, p=0.000), and sSVD values were lower than iSVD at 1-2 months (p=0.010). Statistically significant correlations were found between wRPC and wRNFL values at 3-6 months (r=0.626, p=0.022), between wSVD and wGCC at 1-2 weeks and 1-2 months (r=0.570, r=0.436; p=0.007, p=0.048).Conclusion OCT-A revealed a sectorial reduction in vessel density in RPC and macula with the disease progression of NAION from acute to atrophic stages, a classification associated with structural deficits.

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Longitudinal optical coherence tomography study of optic atrophy in secondary progressive multiple sclerosis: Results from a clinical trial cohort

Multiple Sclerosis Journal ◽

10.1177/1352458517739136 ◽

2017 ◽

Vol 25 (1) ◽

pp. 55-62 ◽

Cited By ~ 4

Author(s):

Kimberly M Winges ◽

Charles F Murchison ◽

Dennis N Bourdette ◽

Rebecca I Spain

Keyword(s):

Multiple Sclerosis ◽

Clinical Trial ◽

Optical Coherence Tomography ◽

Brain Atrophy ◽

Disease Duration ◽

Progressive Multiple Sclerosis ◽

Optical Coherence ◽

Whole Brain ◽

Secondary Progressive ◽

Sd Oct

Background: Limited prospective information exists regarding spectral-domain optical coherence tomography (SD-OCT) in secondary progressive multiple sclerosis (SPMS). Objective: Document cross-sectional and longitudinal retinal nerve fiber layer (RNFL) and macular ganglion cell plus inner plexiform layer (GCIPL) features of an SPMS clinical trial cohort. Methods: Prospective, observational study using a 2-year randomized placebo-controlled SPMS trial cohort with yearly SD-OCT testing. Post hoc analysis determined influences of optic neuritis (ON), disease duration, and baseline SD-OCT on annualized atrophy rates and on correlations between OCT and brain atrophy. Results: Mean RNFL and GCIPL values of patients ( n = 47, mean age = 59 years, mean disease duration = 30 years) were significantly lower among eyes with prior ON than those without (no history of ON (NON)). Annualized RNFL (−0.31 µm/year) and GCIPL (−0.29 µm/year) atrophy rates did not differ between ON and NON eyes. Baseline RNFL thickness >75 µm was associated with greater annualized RNFL atrophy (−0.85 µm/year). Neither RNFL nor GCIPL atrophy correlated with whole-brain atrophy. Conclusion: This study suggests that eyes with and without ON history may be pooled for atrophy analysis in SPMS clinical trials using SD-OCT. Low baseline RNFL, small retinal atrophy rates, and lack of correlation with whole-brain atrophy in this population are important trial design considerations.

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Cilioretinal Artery Occlusion Combined with Central Retinal Vein Occlusion: What Is the Best Imaging Modality for the Follow-Up?

Case Reports in Ophthalmological Medicine ◽

10.1155/2017/9032576 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Mahmut Kaya ◽

Taylan Ozturk ◽

Ziya Ayhan ◽

Nilufer Kocak ◽

Suleyman Kaynak

Keyword(s):

Optical Coherence Tomography ◽

Artery Occlusion ◽

Fundus Photography ◽

Oct Angiography ◽

Optical Coherence ◽

Cilioretinal Artery Occlusion ◽

Cilioretinal Artery ◽

Central Retinal Vein ◽

Sd Oct

We report retinal structural changes of a 37-year-old man diagnosed with the concomitant occlusion of cilioretinal artery and central retinal vein. Comprehensive ophthalmological evaluation was performed, followed by spectral-domain optical coherence tomography (SD-OCT, Heidelberg), optical coherence tomography angiography (OCT angiography, Optovue Inc., Fremont, California, USA), fluorescein angiography, and color fundus photography. The use of OCT angiography and en face SD-OCT imaging as an adjunct test to map out correlative paracentral scotomas during follow-up allowed us to evaluate cilioretinal artery occlusion in the best way due to obtaining satisfactory images of the normal retinal vascular networks and areas of nonperfusion and congestion at various retinal levels.

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Optical Coherence Tomography Angiography Monitors Cutaneous Wound Healing under Angiogenesis-Promoting Treatment in Diabetic and Non-Diabetic Mice

Applied Sciences ◽

10.3390/app11052447 ◽

2021 ◽

Vol 11 (5) ◽

pp. 2447

Author(s):

Martin Pfister ◽

Kornelia Schützenberger ◽

Bhavapriya J. Schäfer ◽

Stefan Puchner ◽

Hannes Stegmann ◽

...

Keyword(s):

Wound Healing ◽

Optical Coherence Tomography ◽

Vascular Remodeling ◽

Vessel Density ◽

Oct Angiography ◽

Optical Coherence ◽

Preclinical Research ◽

Vessel Length ◽

Inflammatory Phase ◽

Vessel Tortuosity

During wound healing, the rapid re-establishment of a functional microcirculation in the wounded tissue is of utmost importance. We applied optical coherence tomography (OCT) angiography to evaluate vascular remodeling in an excisional wound model in the pinnae of C57BL/6 and db/db mice receiving different proangiogenic topical treatments. Analysis of the high-resolution OCT angiograms, including the four quantitative parameters vessel density, vessel length, number of bifurcations, and vessel tortuosity, revealed changes of the microvasculature and allowed identification of the overlapping wound healing phases hemostasis, inflammation, proliferation, and remodeling. Angiograms acquired in the inflammatory phase in the first days showed a dilation of vessels and recruitment of pre-existing capillaries. In the proliferative phase, angiogenesis with the sprouting of new capillaries into the wound tissue led to an increase of the OCT angiography parameters vessel density, normalized vessel length, number of bifurcations, and vessel tortuosity by 28–47%, 39–52%, 33–48%, and 3–8% versus baseline, respectively. After the peak observed on study days four to seven, the parameters slowly decreased but remained still elevated 18 days after wounding, indicating a continuing remodeling phase. Our study suggests that OCT angiography has the potential to serve as a valuable preclinical research tool in studies investigating impaired vascular remodeling during wound healing and potential new treatment strategies.

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