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

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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

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

Frontiers in Medicine ◽

10.3389/fmed.2021.708491 ◽

2021 ◽

Vol 8 ◽

Author(s):

Pingting Zhong ◽

Yijun Hu ◽

Lei Jiang ◽

Qingsheng Peng ◽

Manqing Huang ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Area Under The Curve ◽

Retinal Vasculature ◽

Optical Coherence ◽

Microvascular Damage ◽

Total Occlusion ◽

Retinal Microvasculature ◽

Capillary Plexus ◽

Artery Disease

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.

Download Full-text

Diabeteses kisér-károsodás vizsgálata optikai koherencia tomográfián alapuló angiográfiával

Orvosi Hetilap ◽

10.1556/650.2018.30962 ◽

2018 ◽

Vol 159 (8) ◽

pp. 320-326

Author(s):

Cecília Czakó ◽

Gábor László Sándor ◽

Mónika Ecsedy ◽

Zsuzsanna Szepessy ◽

Ágnes Borbándy ◽

...

Keyword(s):

Risk Factors ◽

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Optical Coherence Tomography Angiography ◽

Retinal Vessel ◽

Vessel Density ◽

Diabetic Patients ◽

Optical Coherence ◽

Retinal Microvasculature ◽

Retinal Vessel Density

Abstract: Introduction: Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. Aim: To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. Method: Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA1c, dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. Results: Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (p<0.05). Both vessel density and between-eye asymmetry significantly correlated with diabetes duration (p<0.05) after controlling for the effect of risk factors. The between-eye asymmetry in vessel density was significantly higher in patients without clinically detectable diabetic retinopathy compared to control subjects (p<0.001). Conclusions: There is a decrease in retinal vessel density and an increase in between-eye asymmetry in patients with diabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320–326.

Download Full-text

Decreased Retinal Microvasculature Densities in Pterygium

10.21203/rs.2.9802/v1 ◽

2019 ◽

Author(s):

Feng Wang¹* ◽

Lin-Hong Ye¹²* ◽

Wen-Qing Shi¹ ◽

Biao Li¹ ◽

Qi Lin¹ ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Vascular Density ◽

Retinal Layer ◽

Optical Coherence ◽

Disease Course ◽

Macular Area ◽

Control Subjects ◽

Retinal Microvasculature ◽

Healthy Control

Abstract Abstract Purpose To investigate the retinal vascular network alterations in eyes of patients with pterygium. Method 18 left eyes from 18 female pterygium patients and 18 left eyes from 18 female healthy control subjects were enrolled. Optical coherence tomography angiography (OCTA) images were generated of the superficial retinal layer (SRL) and deeper retinal layer (DRL) of the macular retina for each eye. The microvascular (MIR) and macrovascular (MAR) densities were calculated and MIR, MAR, and total MIR (TMI) density was compared in the healthy control and pterygium groups. Results In pterygium group, in the SRL, the vascular density in SMIR (superficial MIR), SR, IR, R, SC1, SC2 and SC3 decreased significantly in the macular area (P<.05). Furthermore, the vascular density in all those decreased regions except R, was significantly and negatively correlated with the disease course ( r=-0.6038 to -0.7762, P=0.0008), and the area size of pterygium (r=-0.6043 to -0.9508, P<0.05). For the DRL, the density of DTMI, DMIR (deeper MIR), SR, IR, R, DC2 and DC3 decreased significantly in macular area of pterygium patients (P<.05). Furthermore, the vascular density in all those decreased regions was significantly and negatively correlated with the disease course (r=-0.6901 to -0.7795, P=0.0015), and the area size of pterygium (r=-0.6043 to -0.9563, P<0.05). No statistically significant differences and correlation was found in other region density (|r|＜0.47, P>0.05). Conclusion OCTA findings suggested that pterygium patients present with decreased retinal MIR density, which was negatively correlated with the disease course and the area size of pterygium.

Download Full-text

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.

Download Full-text

Retinal Vascular Features in Ocular Blunt Trauma by Optical Coherence Tomography Angiography

Journal of Clinical Medicine ◽

10.3390/jcm9103329 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3329 ◽

Cited By ~ 1

Author(s):

Daniela Montorio ◽

Luca D’Andrea ◽

Gilda Cennamo

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Optical Coherence Tomography Angiography ◽

Control Group ◽

Optical Coherence ◽

Vascular Perfusion ◽

Retinal Microvasculature ◽

Capillary Plexus ◽

Commotio Retinae ◽

Sd Oct

In this prospective study, we analysed the changes in retinal vessel density (VD) using optical coherence tomography angiography (OCTA) in patients with commotio retinae up to 6 months after blunt ocular trauma. We analysed the VD in the superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) and the foveal avascular zone (FAZ) area at 48 h, and 1, 3 and 6 months after the trauma and compared results with those of healthy fellow eyes. We also evaluated the best-corrected visual acuity (BCVA) and the structural, spectral domain (SD)-OCT parameters: ganglion cell complex (GCC) and retinal nerve fibre layer (RNFL). A total of 18 eyes of 18 patients (8 males, 10 females, mean age 49.61 ± 9.2 years) and 18 healthy control eyes were evaluated. GCC and RNFL thicknesses showed a significant trend towards progressively lower values from 1 month and 3 months after the trauma, respectively, compared to healthy eyes (p < 0.005). The reduction in SD-OCT parameters reached a plateau at 6 months. Similar behaviour was found in the VD of the SCP and RPC that significantly decreased, starting from 1 and 3 months after the trauma, respectively (p < 0.001). At 6 months, the VD values were stable. The DCP presented an initial decrease of VD (p < 0.001), and after 1 month, the values statistically increased until the sixth month, reaching values similar to those of the control group. The FAZ area and BCVA did not show statistically significant changes during the follow-up. OCTA provided a detailed and quantitative analysis of early retinal vascular perfusion alterations after commotio retinae, demonstrating that the impairment of the retinal microvasculature and its progressive changes over time occurred even in the absence of compromised visual acuity.

Download Full-text