scholarly journals Quantification of macular perfusion in healthy children using optical coherence tomography angiography

Author(s):  
Fariba Ghassemi ◽  
Vahid Hatami ◽  
Farhad Salari ◽  
Fatemeh Bazvand ◽  
Hadi Shamouli ◽  
...  

Abstract Background This study aimed at defining the variance of vessel density (VD) characteristics in the macula of children with normal eyes. Methods This was a cross-sectional study in which subjects with normal eyes aged 3–18 years were enrolled. The macula was scanned by optical coherence tomography angiography (OCTA). Four age groups as under 7 years, 7–10 years, 11–14 years and more than 14 years of age were defined. The influences of age, gender, and body mass index on VD were analyzed. Results A total of 108 normal eyes from 54 participants with a mean age of 10.9 years were enrolled in the study. At the superficial and deep retina capillary plexus (SCP and DCP) and choriocapillaris (CC), respectively, the mean VD of the fovea was 20.10%, 36.99%, and 75.67%; at parafovea, these measurements were 53.12%, 55.81%, and 69.76%; and at perifovea, these measures were 51.38%, 52.46%, and 73.47%. The median foveal avascular zone (FAZ) was 0.30 mm2. No significant differences between superior-hemi VD and inferior-hemi VD were found in the studied plexuses. The VD at parafovea and perifovea CC differed significantly between groups. There was no variation in VD of macular retina and CC between eyes or sex. FAZ areas were different between genders. Conclusions No difference between eyes and genders in the retina and CC VD of macular area was noted. FAZ area was larger in male. Even though this is not a longitudinal study, it may provide us with hints about macular vascular development during puberty and clinical implications of OCTA in children.

2021 ◽  
Author(s):  
Fariba Ghassemi ◽  
Vahid Hatami ◽  
Farhad Salari ◽  
Fatemeh Bazvand ◽  
Hadi Shamouli ◽  
...  

Abstract Background: Variations in vessel density (VD) patterns of the macula in children of different ages are unknown.Methods: In this cross-sectional study, subjects with normal eyes aged 3–18 years were enrolled. The macula was scanned by optical coherence tomography angiography (OCTA). Four age groups as under 7 years, 7-10 years, 11-14 years and more than 14 years of age were defined. The influences of age, gender, and body mass index on VD were analyzed.Results: A total of 108 normal eyes from 54 participants with a mean age of 10.9 years were enrolled in the study. At the superficial and deep retina capillary plexus (SCP and DCP) and choriocapillaris (CC), the mean VD of the fovea was 20.10%, 36.99%, and 75.67%, respectively; at parafovea, these measurements were 53.12%, 55.81%, and 69.76%, respectively; and at perifovea, these measures were 51.38%, 52.46%, and 73.47%, respectively. The median foveal avascular zone (FAZ) was 0.28 mm2. No significant differences were found between the superior-hemi and inferior-hemi VD of the studied plexuses. The VD at CC parafovea and perifovea differed significantly between groups. Neither age nor sex affected the VD of macular retina or CC. FAZ areas were different between genders.Conclusions: No difference between eyes and genders in the retina and CC VD of macular area was noted. FAZ area was larger in male. While this study is not a longitudinal study but may give us a hint for the macular vascular development during puberty and clinical applications of OCTA in children.


2020 ◽  
Author(s):  
Laura Gutierrez-Benitez ◽  
Yolanda Palomino ◽  
Noe Casas

PURPOSE: To develop and evaluate an automated method to measure the foveal avascular zone (FAZ) area in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography (HS-OCTA). This method is referred to as the modified Kanno-Saitama macro (mKSM). METHODS: This cross-sectional study included 29 eyes of 25 healthy volunteers who underwent HS-OCTA at the macular area twice at the same time. Regardless of the quality of the images, all of them were included. Macular data on the superficial vascular plexus, intermediate capillary plexus and deep capillary plexus were processed by mKSM. The FAZ area was measured twice automatically using the mKSM and twice manually by two independent examiners. RESULTS: Intrascan intraclass coefficient ranged from 0,948 to 0,993 for manual measurements and was 1 for mKSM method. Interscan intraclass coefficients ranged from 0,925 to 0,973 for manual measurements and from 0,770 to 0,902 for mKSM method. Despite that the difference between human examiners is smaller than between human examiners and mKSM according to Bland-Altman plots, the scatterplots show a strong correlation between human and automatic measurements. The best results are obtained in intermediate capillary plexus. CONCLUSIONS: Automated determination of the FAZ area in HS-OCTA is feasible and less human-dependent by mKSM even if the image is not perfectly centred or has artefacts. The mKSM processing could contribute to our understanding of the three vascular plexuses.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Zhai ◽  
Wei Fang ◽  
Xueting Yu ◽  
Xinjie Ye ◽  
Lijie Hou

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dunja Bajtl ◽  
Mirjana Bjeloš ◽  
Mladen Bušić ◽  
Ana Križanović ◽  
Leon Marković ◽  
...  

Abstract Background The purpose of this cross-sectional study involving healthy emmetropic four-year-old Caucasian children was to provide a macular perfusion normative database acquired with optical coherence tomography angiography (OCTA). One eye of each examinee underwent OCTA imaging. The following parameters were analyzed using AngioTool Image J software: vessels area (VA), vessels density (VD), total number of junctions (TNJ), junctions density (JD), total vessel length (TVL), average vessel length (AVL), total number of endpoints (TNEP), lacunarity (L), vessel diameter index (VDI), tortuosity (T) and foveal avascular zone (FAZ). Average central macular thickness (CMT) and average central macular volume (CMV) were measured. Result Sixty-two eyes of 62 children of average age 50.4 ± 3.8 months were examined. VA, VD, and T increased from the inner towards the outer layers of the retina. The intermediate capillary plexus had the highest JD and TNEP and narrowest FAZ. Retinal sexual differentiation was supported with higher values of the retinal VA, VDI and TNEP, and chorioretinal VA, VDI and L in males. The choriocapillaris presented with the highest VD, AVL, and T and the lowest L and TNEP. Conclusion The study provides the first detailed normative database of the macular vascular network in the youngest uniform cohort of emmetropic four-year-old children.


Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 276
Author(s):  
Gilda Cennamo ◽  
Daniela Montorio ◽  
Giuliano Mazzella ◽  
Paolo Ricchi ◽  
Silvia Costantini ◽  
...  

In this cross-sectional study we assessed the vascular alterations in retinal and choriocapillaris perfusion in patients affected by β-thalassemia, by means of optical coherence tomography angiography (OCTA). A total of 124 eyes of 62 patients (mean age 44.74 ± 5.79 years old) affected by β-thalassemia (transfusion dependent thalassemia (TDT), non-transfusion dependent thalassemia (NTDT) and minor) were compared to 40 eyes of twenty healthy subjects. We evaluated the vessel density (VD) in superficial capillary plexus, deep capillary plexus, radial peripapillary capillary, choriocapillaris and the foveal avascular zone area. The TDT group showed a statistically significant reduction in retinal and choriocapillaris VD respect to controls and the other groups (p < 0.05). No statistically significant difference was found in OCTA parameters between β-thalassemia minor and controls. The NTDT group showed a significant reduction in VD in deep capillary plexus respect to controls and β-thalassemia minor. Significant negative correlations were shown in TDT group between foveal avascular zone and hemoglobin (r = −0.437, p = 0.044) and between ferritin levels and VD of choriocapillaris (r = −0.431, p = 0.038). The OCTA parameters provided a deeper understanding on retinal and choriocapillaris vascular impairment affected by tissue hypoxia levels and the oxidative stress in different clinical phenotypes of the β-thalassemia.


2021 ◽  
Vol 14 (5) ◽  
pp. e240208
Author(s):  
Hana A Mansour ◽  
Sami Uwaydat ◽  
Muhamad H Yunis ◽  
Ahmad M Mansour

Optical coherence tomography angiography imaging in two patients with oculocutaneous albinism, one with severe nystagmus, showed persistence of both the superficial and the deep retinal capillary plexus adding another vascular feature to the foveal hypoplasia.


2019 ◽  
Vol 30 (6) ◽  
pp. 1418-1423 ◽  
Author(s):  
Claudio Furino ◽  
Grazia Montrone ◽  
Maria Vittoria Cicinelli ◽  
Stefania Balestra ◽  
Maria Oliva Grassi ◽  
...  

Purpose: To investigate a subset of diabetic patients without diabetic retinopathy with optical coherence tomography angiography, assessing the differences in macular perfusion between diseased eyes and healthy controls. Methods: Monocentric cross-sectional study, including 86 eyes from 43 diabetic patients with no clinical signs of diabetic retinopathy and 78 eyes from 39 controls. Patients underwent 3.0 × 3.0 mm and 4.5 × 4.5 mm swept-source optical coherence tomography angiography. Vessel density (%), foveal avascular zone area (mm2), and avascular density (%) were provided for the superficial capillary plexus and the deep capillary plexus. Results: The foveal avascular zone area at the superficial capillary plexus was larger in the study group compared to controls, irrespective of the area of the slab considered. A meaningful difference was found in the vessel density at the deep capillary plexus of the 3.0 × 3.0 mm slab (p = 0.03). Almost all the variables considered in the study showed a significant within-subject effect. Age significantly correlated with vessel density of superficial capillary plexus on 4.5 × 4.5 mm in both control and diabetic eyes. Conclusion: Diabetic patients with subclinical diabetic retinopathy feature a larger foveal avascular zone at the superficial capillary plexus compared with controls, as well as relative reduction of the vessel density at the deep capillary plexus. These findings might serve as the basis for screening between normal and diabetic subjects.


2020 ◽  
Vol 30 (3) ◽  
pp. 600-607
Author(s):  
Elif Güler Kazancı ◽  
Muhammet Furkan Korkmaz ◽  
Mehmet Erol Can

Purpose: The purpose was to evaluate retinal vascular parameters by optical coherence tomography angiography in β-thalassemia major patients. Methods: Thirty-three patients with β-thalassemia major (study group) and 29 healthy children (control group) were enrolled in the study. All subjects underwent a complete ocular examination. The mean foveal avascular zone, non-flow area, foveal avascular zone perimeter, acircularity index of foveal avascular zone, foveal density, the superficial capillary plexus, and deep capillary plexus were scanned using 6 × 6 mm optical coherence tomography angiography scans centered on the macula. Superficial capillary plexus and deep capillary plexus were also scanned centered on the optic disk. We collected data on histories of patients, and hemoglobin and ferritin were also studied from both groups. Results: The mean age was 13.85 ± 4.69 years (range: 4–21 years) in β-thalassemia major group and 12.59 ± 3.66 years (range: 6–18 years) in the control group. The mean foveal avascular zone value was 0.265 ± 0.11 mm2 in the study group and 0.296 ± 0.12 mm2 in the control group. The mean non-flow area value was 0.468 ± 0.12 mm2 in the study group and 0.479 ± 0.14 mm2 in the control group ( p > 0.05). Differences in the mean values for foveal density and acircularity index were statistically significant between the study group and control group ( p < 0.05, p = 0.026, and p = 0.026, respectively). Superficial capillary plexus and deep capillary plexus were not a significant difference between the study and control groups in 6 × 6 mm scans on macula and 4.5 × 4.5 mm scans on optic disk area ( p > 0.05). Acircularity index was negatively correlated ( r = −0.292, p = 0.026), and foveal density was positively correlated with hemoglobin ( r = 0.292, p = 0.026). Conclusion: By using optical coherence tomography angiography, we detected foveal microvascular changes in young β-thalassemia patients before significant ocular anomalies development.


2020 ◽  
pp. 247412642095396
Author(s):  
Cason B. Robbins ◽  
Dilraj S. Grewal ◽  
Atalie C. Thompson ◽  
Stephen P. Yoon ◽  
Brenda L. Plassman ◽  
...  

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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