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

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 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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Quantitative assessment and determinants of the papillary microvasculature in healthy subjects

BMC Ophthalmology ◽

10.1186/s12886-021-01896-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Li-jun Zhou ◽

Xiu-zhi Luo ◽

Pei-yang Shen ◽

Xin Li ◽

Peng Su ◽

...

Keyword(s):

Optic Disc ◽

Healthy Subjects ◽

Southern China ◽

Cross Sectional Study ◽

Vessel Density ◽

Cross Sectional ◽

Disc Area ◽

Systemic Factors ◽

Generalized Estimation Equation ◽

Disc Region

Abstract Background It is critical to monitor the optic disc’s vessel density using Optical coherence tomography angiography (OCTA) and evaluate its determinants. In the current study, we investigate the superficial vessel density (VD) of the papillary microvasculature and its determinants in healthy subjects of Southern China. Methods This was a prospective, cross-sectional study. Superficial VD in healthy individuals’ optic disc region was measured by OCTA. The factors associated with ocular and systemic parameters were analyzed using a generalized estimation equation (GEE) model. Results A total of 510 eyes of 260 healthy subjects were analyzed in the study. The total VD in the optic disc area was 17.21 ± 2.15 mm− 1 (95% CI, 17.02–17.40 mm− 1). The VD in the inner ring and the outer ring of the optic disc were significantly higher compared with the central ring, while the VD of the superior quadrant and inferior quadrant was significantly higher compared with the temporal and nasal quadrant. After adjusting for the ocular factors and systemic factors, AL (β = − 0.4917, P = 0.0003), disc area (β = − 0.3748, P = 0.0143), CMT (β = − 0.0183, P = 0.0003) and SSI (β = 1.0588, P < 0.001) were significantly associated with total VD of the optic disc. Conclusion The mean total VD in the optic disc area was 17.21 ± 2.15 mm− 1 in healthy subjects, and the superior and inferior VD was significantly higher than the temporal and nasal VD. AL, disc area, CMT, and SSI may affect the total VD in the optic disc area and should be considered in clinical practice.

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

Scientific Reports ◽

10.1038/s41598-021-02554-y ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Dulce Milagros Razo Blanco-Hernández ◽

Selma Alin Somilleda-Ventura ◽

Rebeca Chávez-Herrera ◽

María Guadalupe Colas-Calvere ◽

Virgilio Lima-Gómez

Keyword(s):

Regression Model ◽

Cross Sectional Study ◽

Quadratic Equation ◽

Vessel Density ◽

Retinal Vessels ◽

Cross Sectional ◽

Capillary Plexus ◽

Group 2 ◽

Perfusion Density ◽

Superficial Capillary Plexus

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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Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

Palliative & Supportive Care ◽

10.1017/s1478951520000164 ◽

2020 ◽

Vol 18 (6) ◽

pp. 658-661

Author(s):

Mafalda Lemos Caldas ◽

Miguel Julião ◽

Ana João Santos ◽

Harvey Max Chochinov

Keyword(s):

Primary Care ◽

Health Care Providers ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Clinical Tool ◽

Cross Sectional ◽

Old Patients ◽

Promising Tool ◽

Palliative Patients

AbstractIntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.

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Multimorbidity patterns in old adults and their associated multi-layered factors: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02292-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiao Lu ◽

Yuan Wang ◽

Lihong Hou ◽

Zhenxing Zuo ◽

Na Zhang ◽

...

Keyword(s):

Latent Class ◽

Metabolic Diseases ◽

Ecological Model ◽

Explanatory Power ◽

Cross Sectional Study ◽

Shanxi Province ◽

Cluster Sampling ◽

Cross Sectional ◽

Old Patients ◽

Old Adults

Abstract Background Influenced by various factors such as socio-demographic characteristics, behavioral lifestyles and socio-cultural environment, the multimorbidity patterns in old adults remain complex. This study aims to identify their characteristics and associated multi-layered factors based on health ecological model. Methods In 2019, we surveyed a total of 7480 participants aged 60+ by using a multi-stage random cluster sampling method in Shanxi province, China. Latent class analysis was used to discriminate the multimorbidity patterns in old adults, and hierarchical regression was performed to determine the multi-layered factors associated with their various multimorbidity patterns. Results The prevalence of multimorbidity was 34.70% among the old patients with chronic disease. Over half (60.59%) of the patients with multimorbidity had two co-existing chronic diseases. “Degenerative/digestive diseases”, “metabolic diseases” and “cardiovascular diseases” were three specific multimorbidity patterns. Behavioral lifestyles-layered factors had the most explanatory power for the three patterns, whose proportions of explanatory power were 54.00, 43.90 and 48.15% individually. But the contributions of other multi-layered factors were different in different patterns; balanced diet, medication adherence, the size of family and friendship network, and different types of basic medical insurance might have the opposite effect on the three multimorbidity patterns (p < 0.05). Conclusions In management of old patients with multimorbidity, we should prioritize both the “lifestyle change”-centered systematic management strategy and group-customized intervention programs.

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Measures of Bioavailable Serum Testosterone and Estradiol and Their Relationships with Muscle Strength, Bone Density, and Body Composition in Elderly Men*

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.9.6825 ◽

2000 ◽

Vol 85 (9) ◽

pp. 3276-3282 ◽

Cited By ~ 12

Author(s):

Annewieke W. van den Beld ◽

Frank H. de Jong ◽

Diederick E. Grobbee ◽

Huibert A. P. Pols ◽

Steven W. J. Lamberts

Keyword(s):

Body Composition ◽

Muscle Strength ◽

Fat Mass ◽

Cross Sectional Study ◽

Positive Relation ◽

Elderly Men ◽

Cross Sectional ◽

Healthy Elderly ◽

Hip Bmd ◽

Best Parameter

Abstract In the present cross-sectional study of 403 independently living elderly men, we tested the hypothesis that the decreases in bone mass, body composition, and muscle strength with age are related to the fall in circulating endogenous testosterone (T) and estrogen concentrations. We compared various measures of the level of bioactive androgen and estrogen to which tissues are exposed. After exclusion of subjects with severe mobility problems and signs of dementia, 403 healthy men (age, 73–94 yr) were randomly selected from a population-based sample. Total T (TT), free T (FT), estrone (E1), estradiol (E2), and sex hormone-binding globulin (SHBG) were determined by RIA. Levels of non-SHBG-bound T (non-SHBG-T), FT (calc-FT), the TT/SHBG ratio, non-SHBG-bound E2, and free E2 were calculated. Physical characteristics of aging included muscle strength measured using dynamometry, total body bone mineral density (BMD), hip BMD, and body composition, including lean mass and fat mass, measured by dual-energy x-ray absorptiometry. In this population of healthy elderly men, calc-FT, non-SHBG-T, E1, and E2 (total, free, and non-SHBG bound) decreased significantly with age. T (total and non-SHBG-T) was positively related with muscle strength and total body BMD (for non-SHBG-T, respectively, β = 1.93 ± 0.52, P < 0.001 and β = 0.011 ± 0.002, P < 0.001). An inverse association existed between T and fat mass (β = −0.53 ± 0.15, P < 0.001). Non-SHBG-T and calc-FT were more strongly related to muscle strength, BMD, and fat mass than TT and were also significantly related to hip BMD. E1 and E2 were both positively, independently associated with BMD (for E2, β = 0.21 ± 0.08, P < 0.01). Non-SHBG-bound E2 was slightly strongly related to BMD than total E2. The positive relation between T and BMD was independent of E2. E1 and E2 were not related with muscle strength or body composition. In summary, bioavailable T, E1, total E2, and bioavailable E2 all decrease with age in healthy old men. In this cross-sectional study in healthy elderly men, non-SHBG-bound T seems to be the best parameter for serum levels of bioactive T, which seems to play a direct role in the various physiological changes that occur during aging. A positive relation with muscle strength and BMD and a negative relation with fat mass was found. In addition, both serum E1 and E2 seem to play a role in the age-related bone loss in elderly men, although the cross-sectional nature of the study precludes a definitive conclusion. Non-SHBG-bound E2 seems to be the best parameter of serum bioactive E2 in describing its positive relation with BMD.

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Association between glaucomatous optic disc and depressive symptoms independent of light exposure profiles: a cross-sectional study of the HEIJO-KYO cohort

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312176 ◽

2018 ◽

Vol 103 (8) ◽

pp. 1119-1122 ◽

Cited By ~ 2

Author(s):

Tadanobu Yoshikawa ◽

Kenji Obayashi ◽

Kimie Miyata ◽

Tetsuo Ueda ◽

Norio Kurumatani ◽

...

Keyword(s):

Depressive Symptoms ◽

Optic Disc ◽

Light Exposure ◽

Depression Scale ◽

Cross Sectional Study ◽

Confounding Factors ◽

Sectional Study ◽

Night Time ◽

Cross Sectional ◽

Optic Discs

BackgroundGlaucoma may cause physiological and behavioural circadian misalignment because of the loss of intrinsically photosensitive retinal ganglion cells, the primary receptors of environmental light. Although studies have suggested a high prevalence of depression in patients with glaucoma, it is unclear whether the association is independent of the light exposure profiles as an important confounding factor.MethodsIn this cross-sectional study of a community-based cohort of 770 elderly individuals (mean age, 70.9 years), glaucomatous optic discs were assessed using fundus photographs and depressive symptoms were assessed using the short version of the Geriatric Depression Scale (GDS). Daytime and night-time ambient light exposures were objectively measured for 2 days.ResultsDepressive symptoms (GDS score ≥6) were observed in 114 participants (prevalence, 14.8%) and glaucomatous optic discs were detected in 40 participants (prevalence, 5.2%). The prevalence of depressive symptoms was significantly higher in the group with glaucomatous optic disc than in the group without it (30.0% vs 14.0%, respectively; p=0.005). Multivariable logistic regression analysis adjusted for potential confounding factors, including daytime and night-time light exposures, revealed that the OR for depressive symptoms was significantly higher in the group with glaucomatous optic disc than in the group without it (OR 2.45, 95% CI 1.18 to 5.08; p=0.016).ConclusionsIn this general elderly population, glaucomatous optic disc was significantly associated with higher prevalence of depressive symptoms independent of a number of potential confounding factors, including daily light exposure profiles.

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Clinical Characteristics of Pigment Dispersion Syndrome and Pigmentary Glaucoma Patients: A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/46939.14383 ◽

2020 ◽

Author(s):

Vijay Pratap Singh Tomar ◽

Sandeep Sharma ◽

Rahul Bhardwaj ◽

Sindhuja Singh ◽

Virendra Kumar Pal ◽

...

Keyword(s):

Visual Field ◽

Optic Disc ◽

Clinical Characteristics ◽

Cross Sectional Study ◽

Pigment Dispersion ◽

Pigmentary Glaucoma ◽

Spherical Equivalent ◽

Sectional Study ◽

Cross Sectional ◽

Pigment Dispersion Syndrome

Introduction: Pigmentary Glaucoma (PG) and Pigment Dispersion Syndrome (PDS) are two different spectrums of a single disease. Since the disease is seen in younger population and is rapidly progressive blinding disease, therefore early diagnosis and treatment will reduce the burden of the disease and improve the quality of life. Aim: To evaluate clinical characteristics of PDS and PG patients in eastern part of Uttar Pradesh. Materials and Methods: This was a two years (1st January 2018 to 31st December 2019) hospital‑based retrospective cross‑sectional study of patients who attended the glaucoma clinic. Diagnosis of PDS was made when they had normal optic disc, normal visual field {with or without increased Intra Ocular Pressure (IOP)} and at least two of the following three signs were found clinically: Krukenberg spindle, homogenous moderate‑to‑heavy (≥Spaeth 2+) Trabecular Meshwork (TM) pigmentation, and any degree of zonular and/or lenticular pigment granule dusting. Patients with PDS were diagnosed with PG, if they had two or more of the following findings: initial IOP >21 mmHg, glaucomatous optic nerve damage or glaucomatous visual field loss. Various parameters such as influence of demographics, IOP, Best‑Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT), Mean Deviation (MD), Visual Field Index (VFI %), spherical equivalent and clinical finding of anterior segment of study patients were analysed. Mean, standard deviation and percentage were calculated using GraphPad Instat version 3.0. Results: Among 40 patients, nine eyes of the six patients had myopia of ‑0.5D or greater, with mean refractive error of ‑3.55±4.72 spherical equivalent. The average baseline IOP in study patients (PDS+PG), was 30.21±11.42 mmHg. Twenty four (60%) patients, either in one or both eyes had glaucoma, secondary to PDS at the initial diagnosis. Thirty three (82.5%) patients had Krukenberg spindles. Homogeneous TM pigmentation was seen in all patients. Typical spoke‑like radial Iris Transillumination Defects (ITDs) were not observed in any of the patients except in one patient, who had isolated short slit‑like trans‑illumination defects in iris crypts. Conclusion: PDS patients with normal optic disc and visual field and raised IOP, should be started prophylactic treatment and needs to be monitored more closely. Thus, the finding of PDS in Indians should alert the ophthalmologist to look for glaucoma during the initial examination.

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