Retinal Microvasculature Changes in Patients With Coronary Total Occlusion on Optical Coherence Tomography Angiography

Background: Retinal microvasculature has been associated with coronary artery disease (CAD), but the exact contributory role in coronary total occlusion (CTO) is unclear. We aimed to investigate whether retinal vasculature is associated with CTO and could provide incremental value in the assessment of CTO.Methods: A total of 218 CAD patients including 102 CTO and 116 non-CTO were enrolled. Retinal vasculature was measured by optical coherence tomography angiography (OCTA) for all patients. Receiver operating characteristic (ROC) curve was used to assess the performance of retinal vasculature in differentiating CTO from non-CTO patients.Results: In non-CTO CAD patients, vessel density (VD) of mean superficial capillary plexus (SCP) and parafovea SCP were 49.85 and 52.56%, respectively; in CTO patients, VD of mean SCP and parafovea SCP were 47.77, and 49.58%, respectively. After multiple adjustment, VD in the SCP was significantly lower in CTO patients compared to non-CTO patients. VD of superior hemi in the parafovea SCP combined with the clinical variates showed the best ability to predict CTO from CAD with an area under the curve (AUC) of 0.812 (specificity of 89.0% and sensitivity of 65.9%).Conclusions: In CTO patients, retinal VD was significantly decreased, and microvascular damage might specifically target to arterioles than capillaries. Retinal vasculature could thus be a surrogate for detecting the microvascular damage and assist in the assessment of CTO patients. OCTA examination could be suggested to monitor the process of coronary arteries lesions.

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Assessment of Macular Capillary Perfusion by Optical Coherence Tomography Angiography on Quiescent Unilateral Anterior Pediatric Uveitis

10.21203/rs.3.rs-967105/v1 ◽

2021 ◽

Author(s):

Junyan Xiao ◽

Yi Qu ◽

Chan Zhao ◽

Hang Song ◽

Anyi Liang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Foveal Avascular Zone ◽

Flow Density ◽

Vascular Density ◽

Optical Coherence ◽

Pediatric Uveitis ◽

Retinal Microvasculature ◽

Capillary Plexus ◽

Fellow Eyes

Abstract Purpose: Using spectral domain optical coherence tomography angiography (SD-OCTA) to evaluate tomographic and microvascular parameters in the macula in quiescent unilateral anterior pediatric uveitis (APU) patients.Methods: Forty-two eyes of 21 patients diagnosed with unilateral APU and 21 eyes of 21 normal controls (NC) were included in this study. 6*6 mm macular scanning mode of SD-OCTA was used for all subjects. The central macular thickness (CMT), subfoveal choroidal thickness (SFCT), vascular density (VD) of superficial capillary plexus (SCP) and the deep capillary plexus (DCP), the foveal avascular zone (FAZ) area, and choriocapillary flow density (CFD) were analyzed and compared among affected, fellow, and NC eyes. Correlation analysis were used to evaluate the potential correlating factors with CFD.Results: DCP VD and CFD were significantly lower in quiescent affected eyes as compared to fellow and NCs eyes (DCP VD both p<0.001; CDF1.0: p=0.012 and p=0.003; CDF1.5: p=0.015 and p=0.006; CDF3.0: p=0.036 and p=0.010, respectively). SCP VD, DCP VD and CMT were significantly lower in the fellow eyes as compared to NC eyes (p=0.021; p<0.001; p=0.037, respectively); CFD was negatively correlated with FAZ and CMT in affected eyes and fellow eyes. No significant differences were detected in FAZ among the 3 groups (p > .05).Conclusions: As compared to NC eyes, both retinal and choroidal microvasculature were impaired in eyes with quiescent APU; retinal microvasculature in unaffected fellow eyes of unilateral APU was also impaired. OCTA is a useful technology for detection of subclinical microvascular changes in APU and may be useful as an additional prognostic tool.

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Plexus-specific effect of flicker-light stimulation on the retinal microvasculature assessed with optical coherence tomography angiography

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00495.2020 ◽

2021 ◽

Vol 320 (1) ◽

pp. H23-H28

Author(s):

Martin Kallab ◽

Nikolaus Hommer ◽

Bingyao Tan ◽

Martin Pfister ◽

Andreas Schlatter ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Specific Effect ◽

Optical Coherence ◽

Specific Mechanism ◽

Physiological Importance ◽

Retinal Microvasculature ◽

Capillary Plexus ◽

Flicker Stimulation ◽

Superficial Capillary Plexus

We present vessel density alterations in response to flicker stimulation using optical coherence tomography angiography and identified the superficial capillary plexus as the layer with the most pronounced effect. This points out the physiological importance of the microvasculature in mediating functional hyperemia and suggests a fine-tuned plexus-specific mechanism to meet cellular metabolic demands.

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Assessment of the retinal vasculature in healthy Chinese preschool children aged 4–6 years old using optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-021-02154-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lu Xiang ◽

Yingming Zhou ◽

Yanwei Chen ◽

Siyu Jiang ◽

Chunli Fei ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Preschool Children ◽

Optic Disc ◽

Optical Coherence Tomography Angiography ◽

Vessel Density ◽

Retinal Vasculature ◽

Optical Coherence ◽

Significant Difference ◽

Capillary Plexus ◽

The Mean

Abstract Purpose To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4–6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. Methods In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. Results A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. Conclusions Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.

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Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-319540 ◽

2021 ◽

pp. bjophthalmol-2021-319540

Author(s):

Jade Y. Moon ◽

Itika Garg ◽

Ying Cui ◽

Raviv Katz ◽

Ying Zhu ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Choroidal Thickness ◽

Optical Coherence Tomography Angiography ◽

Foveal Avascular Zone ◽

Systemic Hypertension ◽

Wide Field ◽

Optical Coherence ◽

Swept Source ◽

Retinal Microvasculature ◽

Capillary Plexus

Background/aimsPathological myopia (PM) is a leading cause of blindness worldwide. We aimed to evaluate microvascular and chorioretinal changes in different stages of myopia with wide-field (WF) swept-source (SS) optical coherence tomography angiography (OCTA).MethodsThis prospective cross-sectional observational study included 186 eyes of 122 patients who had undergone imaging between November 2018 and October 2020. Vessel density (VD) and vessel skeletonised density (VSD) of superficial capillary plexus, deep capillary plexus and whole retina, as well as foveal avascular zone parameters, retinal thickness (RT) and choroidal thickness (CT), were calculated.ResultsThis study evaluated 75 eyes of 48 patients with high myopia (HM), 43 eyes of 31 patients with mild to moderate myopia and 68 eyes of 53 age-matched controls. Controlling for age and the presence of systemic hypertension, we found that HM was associated with decrease in VD and VSD in all layers on 12×12 mm² scans. Furthermore, HM was associated with a VD and VSD decrease in every Early Treatment Diabetic Retinopathy Study grid, with a larger decrease temporally (βVD=−0.39, βVSD=−10.25, p<0.01). HM was associated with decreased RT and CT. Reduction in RT was outside the macular region, while reduction in CT was in the macular region.ConclusionUsing WF SS-OCTA, we identified reduction in microvasculature and structural changes associated with myopia. Decrease in VD and VSD was greater in the temporal quadrant, and reductions in RT and CT were uneven across the retina. Further work may help identify risk factors for the progression of PM and associated vision-threatening complications.

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Optical Coherence Tomography Angiography Findings in Fabry Disease

Journal of Clinical Medicine ◽

10.3390/jcm8040528 ◽

2019 ◽

Vol 8 (4) ◽

pp. 528 ◽

Cited By ~ 7

Author(s):

Gilda Cennamo ◽

Laura Giovanna Di Maio ◽

Daniela Montorio ◽

Fausto Tranfa ◽

Camilla Russo ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Fabry Disease ◽

Optical Coherence Tomography Angiography ◽

Retinal Vessel ◽

Vessel Density ◽

Vascular Density ◽

Optical Coherence ◽

Lysosomal Storage ◽

Retinal Microvasculature ◽

Capillary Plexus

Background: Fabry disease (FD) is a X-linked recessive lysosomal storage disorder characterized by altered biodegradation of glycosphingolipids. It is a multisystem pathology, also involving ophthalmological systems that show modifications of the vessel wall due to glycosphingolipid deposits. Optical coherence tomography angiography (OCT-A) allows for an objective analysis of retinal microvasculature alterations, evaluating retinal vessel density in macular region. Methods: A total of 54 FD patients (34 females, 20 males, mean age 44.1 ± 15.6 years) and 70 controls (36 females, 34 males, mean age 42.3 ± 15.6 years) were included in this study. We evaluated vessel density in different macular areas (whole image, fovea, and parafovea) of both the superficial capillary plexus (SCP) and of the deep capillary plexus (DCP). Results: In the SCP there was a significantly lower vascular density in patients compared with controls in whole image (49.95 ± 5.17% vs. 51.99 ± 2.52%; p < 0.001), parafovea (52.01 ± 6.69% vs. 54.30 ± 2.61%; p = 0.002), and fovea (22.38 ± 9.01% vs. 29.31 ± 5.84%; p < 0.0001). In the DCP the vessel density was statistically increased in each macular area in patients compared with controls (54.82 ± 8.07% vs. 50.93 ± 5.46%; p = 0.005, 57.76 ± 7.26% vs. 53.59 ± 5.46%; p = 0.0001, and 39.75 ± 8.59% vs. 34.43 ± 8.68%; p < 0.0001 for whole image, parafovea, and fovea, respectively). Conclusion: OCT-A analysis showed that the macular vessel density was significantly reduced in the SCP and increased in the DCP in FD patients compared with controls. These findings, which might be a consequence of the alteration of vascular wall occurring in FD, support the hypothesis that the evaluation of early retinal microvascular network changes could be a useful tool in the clinical evaluation of the disease.

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Detection of retinal changes with optical coherence tomography angiography in mild cognitive impairment and Alzheimer’s disease patients: A meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0255362 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255362

Author(s):

Jingwen Hui ◽

Yun Zhao ◽

Shasha Yu ◽

Jinfeng Liu ◽

Kin Chiu ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Optical Coherence Tomography ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Optical Coherence Tomography Angiography ◽

Meta Analysis ◽

Optical Coherence ◽

Retinal Microvasculature ◽

Capillary Plexus

Objective To assess retinal microvascular network impairments in the eyes of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) patients with optical coherence tomography angiography (OCTA). Design Systematic review and meta-analysis. Methods A literature search was conducted in the PubMed and EMBASE databases to identify relevant studies detecting retinal microvascular attenuation among AD, MCI patients and cognitively healthy controls (HCs) by OCTA. Data were extracted by Review Manager V.5.4 and Stata V.14.0. Results Eight investigations were included in this meta-analysis, with 150 AD patients, 195 MCI patients and 226 HCs were eligible for meta-analysis. Evidence based on these studies demonstrated that there was a significantly decreased vessel density (VD) of the Optovue group in superficial capillary plexus (SCP): WMD = -2.26, 95% CI: -3.98 to -0.55, p = 0.01; in deep capillary plexus (DCP): WMD = -3.40, 95% CI: -5.99 to -0.81, p = 0.01, VD of the Zeiss group in SCP:WMD = -0.91, 95% CI: -1.79 to -0.02, p = 0.05 and an enlarged fovea avascular zone (FAZ):WMD = 0.06, 95% CI: 0.01 to 0.11, P = 0.02 in OCTA measurements of MCI patients. Additionally, in OCTA measurements of AD patients, there was a significantly decreased VD in the SCP: WMD = -1.88, 95% CI: -2.7 to -1.07, p<0.00001. In contrast, there was no significant decrease in DCP nor enlargement of FAZ in AD patients. Conclusion Retinal microvascular alternations could be optimally screened in MCI patients detected by OCTA, which could be a warning sign of relative changes in the MCI before progressing to AD. Retinal microvasculature changes worth further investigation in larger scale clinical trials.

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Optical Coherence Tomography Angiography for the Evaluation of Retinal Vasculature in Fabry Disease: Our Experience and Review of Current Knowledge

Frontiers in Neurology ◽

10.3389/fneur.2021.640719 ◽

2021 ◽

Vol 12 ◽

Author(s):

Daniela Bacherini ◽

Giulio Vicini ◽

Cristina Nicolosi ◽

Ilaria Tanini ◽

Chiara Lenzetti ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Fabry Disease ◽

Optical Coherence Tomography Angiography ◽

Left Ventricular ◽

Current Status ◽

Retinal Vasculature ◽

Optical Coherence ◽

Non Invasive ◽

Capillary Plexus ◽

Objective Tool

Purpose: Optical coherence tomography angiography (OCTA) is a non-invasive and objective tool for the evaluation of the retinal microvascular changes in Fabry disease (FD). We investigated changes in retinal vasculature in FD patients, and the possible correlation with systemic parameters, by using OCTA, and reviewed the current status of literature.Methods: Thirteen FD patients (eight females, five males, mean age 49.85 ± 14.7 years) were compared with 13 age- and sex-matched healthy controls. OCTA 3 × 3 mm macular scans were performed in all subjects. We evaluated the vessel density and vessel perfusion in distinct macular areas (whole, inner, and outer) of both the superficial capillary plexus (SCP VD and SCP VP) and of the deep capillary plexus (DCP VD and DCP VP). We also evaluated the foveal avascular zone (FAZ) metrics (area, perimeter, and circularity), and correlation between systemic and OCTA parameters. A literature review on the current understanding of OCTA in FD is then presented.Results: FD patients showed significantly lower SCP VD values in the whole area (17.37 ± 2.08 mm−1 vs. 18.54 ± 1.21 mm−1; p-value 0.022), as well as in the outer area (17.46 ± 2.10 mm−1 vs. 19.08 ± 1.14 mm−1; p-value 0.002), but not in the inner. Even the DCP VD was significantly lower in all the imaged areas: whole (17.75 ± 3.93 mm−1 vs. 19.71 ± 1.20 mm−1; p-value 0.024), outer (18.25 ± 4.17 mm−1 vs. 20.33 ± 1.20 mm−1; p-value 0.023), and inner (19.54 ± 4.17 mm−1 vs. 21.96 ± 1.55 mm−1; p-value 0.011). There were no significant differences in vessel perfusion parameters (both SCP VP and DCP VP ones) and FAZ. No significant correlations were found between the OCTA parameters and systemic parameters (maximal left ventricular wall thickness and glomerular filtration rate) in FD patients.Conclusions: OCTA can be considered as a promising non-invasive tool, which enables a quantitative evaluation of retinal vascular involvement in FD, despite the varying data reported in literature. Our results support the use of OCTA as an objective tool to evaluate retinal vascular abnormalities in FD. The utility of OCTA in FD needs to be validated by longitudinal studies taking into account the overall progression of the disease.

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Reduced Retinal Microvascular Perfusion in Patients With Stroke Detected by Optical Coherence Tomography Angiography

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.628336 ◽

2021 ◽

Vol 13 ◽

Author(s):

Baoyi Liu ◽

Yijun Hu ◽

Guixian Ma ◽

Yu Xiao ◽

Bin Zhang ◽

...

Keyword(s):

Risk Factors ◽

Optical Coherence Tomography ◽

Protective Factor ◽

Optical Coherence Tomography Angiography ◽

Optic Disk ◽

Optical Coherence ◽

Control Subjects ◽

Retinal Microvasculature ◽

Capillary Plexus ◽

Traditional Risk Factors

Currently there is a shortage of biomarkers for stroke, one of the leading causes of death and disability in aging populations. Retinal vessels offer a unique and accessible “window” to study the microvasculature in vivo. However, the relationship between the retinal microvasculature and stroke is not entirely clear. To investigate the retinal microvascular characteristics in stroke, we recruited patients with stroke and age-matched control subjects from a tertiary hospital in China. The macular vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ) metrics, and optical coherence tomography angiography (OCTA) measured optic disc VD were recorded for analysis. A total of 189 patients with stroke and 195 control subjects were included. After adjusting for sex, visual acuity, systolic and diastolic blood pressure, a history of smoking, levels of hemoglobulin (HbA1c), cholesterol, and high-density lipoprotein (HDL), the macular VD of SCP and DCP in all sectors was decreased in patients with stroke. In the stroke group, the VD around the FAZ and the VD of the optic disk were lower. Logistic regression found the parafovea-superior-hemi VD of DCP > 54.53% [odds ratio (OR): 0.169] as a protective factor of stroke. Using the integration of all OCTA parameters and traditional risk factors, the area under the receiver operating characteristic (AUC) curve of distinguishing patients with stroke was 0.962, with a sensitivity of 0.944 and a specificity of 0.871. Our study demonstrates that the retinal VD is decreased in patients with stroke independently of the traditional risk factors of stroke, which may shed light on the monitoring of stroke using the retinal microvascular parameters.

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Monitoring Ischemic Changes in Retinal Vasculitis With Optical Coherence Tomography Angiography

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419887569 ◽

2019 ◽

Vol 4 (1) ◽

pp. 75-78 ◽

Cited By ~ 1

Author(s):

Alexander B. Dillon ◽

Kyle Kovacs ◽

Anton Orlin

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Retinal Vasculitis ◽

Ischemia And Reperfusion ◽

Optical Coherence ◽

Case Presentation ◽

Retinal Microvasculature ◽

Retinal Capillary ◽

The Status ◽

Capillary Plexus

Purpose: This article illustrates the ability of optical coherence tomography angiography (OCTA) to aid in the diagnostic workup and management of occlusive retinal vasculitis over time. Methods: A case presentation is discussed. Results: In this case, OCTA helped define the extent and evolution of superficial and deep retinal capillary plexus occlusion and reperfusion over the treatment course. Conclusions: OCTA detects blood flow and maps retinal vasculature at the capillary level without the use of intravenous dye. Serial image acquisition can reveal patterns of ischemia and reperfusion in retinal vascular conditions as they evolve and respond to therapy, providing more granular information regarding the status of the retinal microvasculature that may guide treatment.

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Characterization of the Canine Retinal Vasculature With Optical Coherence Tomography Angiography: Comparisons With Histology and Fluorescein Angiography

Frontiers in Neuroanatomy ◽

10.3389/fnana.2021.785249 ◽

2021 ◽

Vol 15 ◽

Author(s):

Ana Ripolles-Garcia ◽

Gordon Ruthel ◽

Gui-Shuang Ying ◽

Yineng Chen ◽

Nicolas Cuenca ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Optical Coherence Tomography Angiography ◽

Ex Vivo ◽

Confocal Imaging ◽

Retinal Vasculature ◽

Optical Coherence ◽

Small Vessels ◽

Capillary Plexus ◽

The Individual

Purpose: To present a methodology for quantification of the canine retinal vasculature imaged by optical coherence tomography angiography (OCTA) and validate this approach by comparison with fluorescein angiography (FA) and confocal imaging of retinal wholemounts labelled by immunohistochemistry (IHC).Methods: Six normal adult dogs underwent retinal OCTA imaging in both eyes. The images extracted from the different microvascular plexuses at eight retinal locations spanning the central and mid-peripheral fundus were analyzed using the AngioTool software. FA was performed in one eye and was compared to the OCTA images. Six eyes from three dogs were processed by IHC to examine the retinal vasculature.Results: A total of four retinal plexuses were identified by OCTA in the canine retina, and their density and topographical pattern varied with eccentricity. OCTA offered improved resolution over FA with the advantage of allowing imaging of the individual plexuses. Detection by OCTA of small vessels within the deep capillary plexus was possible and approached the level of resolution achieved with ex vivo imaging of the retinal vasculature by confocal microscopy/IHC. The plexuses herein described are analogous to human retinal vasculature.Conclusion: OCTA can be used to image and quantify non-invasively the vascular retinal networks of the canine retina. We provide normative data in eight different retinal locations that can be imaged non-invasively with this technology. This could support analysis of retinal vascular changes associated with disease and following therapeutic intervention.

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