scholarly journals Comparison of Different Metrics for the Identification of Vascular Changes in Diabetic Retinopathy Using OCTA

2021 ◽  
Vol 15 ◽  
Author(s):  
Luis Mendes ◽  
Inês P. Marques ◽  
José Cunha-Vaz
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Vessel ◽  
Progressive Increase ◽  
Control Group ◽  
Clinical Value ◽  
Microvascular Changes ◽  
Increased Risk ◽  
En Face ◽  
Vessel Closure ◽  
Capillary Plexus

Retinal vessel metrics identifying microvascular changes such as vessel closure (VC) have shown potential clinical value by identifying eyes with diabetic retinopathy (DR) at different severity levels and at increased risk for disease progression to more severe stages. We compare the performance of 11 different metrics, which include 2 metrics supplied by the manufacturer, based on OCTA for identification of VC in different Early Treatment for Diabetic Retinopathy Study (ETDRS) severity groups. OCTA en-face slabs from 84 healthy eyes (70 ± 4.8 years) and 78 eyes of diabetic individuals (67 ± 7.5 years) were processed using different methods that include abnormal intercapillary spaces (AIS), vessel density (VD), and nine metrics extracted from the en-face slab. The best separation between the eyes with DR and the control group was obtained in the superficial capillary plexus (SCP), with the full retina (FR) also performing well. In the SCP, the metrics that show better performance were the AIS and the VD with a value of area under curve (AUC) equal to 0.89 [95% CI 0.84–0.94] and 0.85 [95% CI 0.79–0.91], respectively, indicating that the VD metric supported by the manufacturer is satisfactory. The values of these metrics on the different ETDRS groups show a progressive increase in VC, which is correlated with disease severity.

scholarly journals Retrospective in silico HLA predictions from COVID-19 patients reveal alleles associated with disease prognosis

2020 ◽  
Author(s):  
René L. Warren ◽  
Inanç Birol
Keyword(s):  
In Silico ◽  
Statistical Significance ◽  
Significant Risk ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Negative Control ◽  
Control Group ◽  
Clinical Value ◽  
Disease Prognosis ◽  
Increased Risk

ABSTRACTBackgroundThe Human Leukocyte Antigen (HLA) gene locus plays a fundamental role in human immunity, and it is established that certain HLA alleles are disease determinants.MethodsBy combining the predictive power of multiple in silico HLA predictors, we have previously identified prevalent HLA class I and class II alleles, including DPA1*02:02, in two small cohorts at the COVID-19 pandemic onset. Since then, newer and larger patient cohorts with controls and associated demographic and clinical data have been deposited in public repositories. Here, we report on HLA-I and HLA-II alleles, along with their associated risk significance in one such cohort of 126 patients, including COVID-19 positive (n=100) and negative patients (n=26).ResultsWe recapitulate an enrichment of DPA1*02:02 in the COVID-19 positive cohort (29%) when compared to the COVID-negative control group (Fisher’s exact test [FET] p=0.0174). Having this allele, however, does not appear to put this cohort’s patients at an increased risk of hospitalization. Inspection of COVID-19 disease severity outcomes reveal nominally significant risk associations with A*11:01 (FET p=0.0078), C*04:01 (FET p=0.0087) and DQA1*01:02 (FET p=0.0121).ConclusionsWhile enrichment of these alleles falls below statistical significance after Bonferroni correction, COVID-19 patients with the latter three alleles tend to fare worse overall. This is especially evident for patients with C*04:01, where disease prognosis measured by mechanical ventilation-free days was statistically significant after multiple hypothesis correction (Bonferroni p = 0.0023), and may hold potential clinical value.

scholarly journals Assessment of the microvasculature in poppers maculopathy

2021 ◽  
Author(s):  
T. Hamann ◽  
M. R. J. Wiest ◽  
M. Brinkmann ◽  
M. Toro ◽  
K. Fasler ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Foveal Avascular Zone ◽  
Control Group ◽  
Optical Coherence ◽  
Vascular Plexus ◽  
Microvascular Changes ◽  
Lesion Type ◽  
Avascular Zone ◽  
Capillary Plexus ◽  
Healthy Control

Abstract Purpose To investigate a possible microvascular component of poppers maculopathy (PMP) using optical coherence tomography angiography (OCTA). Methods Twelve patients suffering from poppers maculopathy were included. Health records, optical coherence tomography (OCT), and OCTA data was gathered and compared to a healthy control group (HC). PMP lesion type was determined by manifestation in OCT. OCTA-based evaluation of retinal vascular plexus and choriocapillaris (CC) was executed. Vessel density (VD) and vessel length density (VLD) in superficial and deep capillary plexus (SCP, DCP), as well as flow deficits (FD), within the foveal avascular zone (FAZ) in CC were assessed. Results Median age of PMP patients was 40 (min 24; max 64) years, all male. Eleven patients presented with ellipsoid zone-type lesions; one patient showed a vitelliform-type lesion. No qualitative microvascular changes between PMP patients and HC were identified. Quantitative values for VD and VLD of SCP and DCP did not differ in between the two groups. The analysis of FDs in CC showed no deviation from PMP patients to HC. Conclusions No vascular anomalies in qualitative and quantitative analysis in OCTA were detected in PMP patients. The constitution of the CC within FAZ of PMP patients does not differ from HC when assessed as FD.

Basic regulatory effects and clinical value of metalloproteinase-14 and extracellular matrix metalloproteinase inducer in diabetic retinopathy

2021 ◽  
Vol 11 (6) ◽  
pp. 873-879
Author(s):  
Shuyan Li ◽  
Shiheng Lu ◽  
Lei Zhang ◽  
Shasha Liu ◽  
Lei Wang ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Diabetic Retinopathy ◽  
Matrix Metalloproteinase ◽  
High Glucose ◽  
Adverse Outcome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Clinical Value ◽  
Extracellular Matrix Metalloproteinase Inducer ◽  
Regulatory Effects

This study examined the basic regulatory effects and clinical value of metalloproteinase-14 and extracellular matrix metalloproteinase inducer in diabetic retinopathy. Seventy-four patients with diabetic retinopathy (study group/diabetic retinopathy (DR) group) and 48 healthy people (control group) were included in this study. Venous blood of subjects in the two groups was collected and the plasma levels of EMMPRIN, MMP-14, VEGF, and MMP-9 were determined by enzyme-linked immunosorbent assay. The value of applying plasma EMMPRIN and MMP-14 for predicting the prognosis of DR was evaluated using a receiver operating characteristic (ROC) curve with a 1-year follow-up. Human umbilical vein endothelial cells (HUVECs) were cultured in high-glucose conditions. EMMPRIN and MMP-14 mRNA levels were determined by RT-qPCR, EMMPRIN and MMP-14 protein levels were determined by Western blotting, apoptosis was determined by flow cytometry, and the level of angiogenesis was recorded. The levels of EMMPRIN and MMP-14 in the DR group were increased compared with those in the control group. Plasma EMMPRIN was positively correlated with plasma MMP-9 and plasma VEGF, and its area under the curve (AUC) for predicting 1-year adverse outcome of DR was 0.676. Plasma MMP-14 was also positively correlated with plasma MMP-9 and plasma VEGF, and its AUC for predicting 1-year adverse outcome of DR was 0.650. EMMPRIN and MMP-14 were upregulated in high-glucose-induced HUVECs. Downregulation of EMMPRIN resulted in downregulation of MMP-14, and downregulation of MMP-14 and EMMPRIN resulted in decreased apoptosis and angiogenesis of HUVECs. These findings suggest that EMMPRIN promotes endothelial cell apoptosis and angiogenesis in DR through MMP-14, and that plasma EMMPRIN and MMP-14 can help predict the short-term prognosis of DR.

scholarly journals The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

2021 ◽  
Vol 10 (12) ◽  
pp. 2659
Author(s):  
Klaudia Rakusiewicz ◽  
Krystyna Kanigowska ◽  
Wojciech Hautz ◽  
Lidia Ziółkowska
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vessel ◽  
Left Ventricular ◽  
Vessel Density ◽  
Control Group ◽  
Study Group ◽  
Capillary Plexus ◽  
Retinal Vessel Density

(1) Introduction: The aim of this study is to assess retinal vessel density (VD) in the superficial capillary plexus layer (SP) and deep capillary plexus layer (DP) in children with chronic heart failure (CHF) in the course of dilated cardiomyopathy (DCM) using optical coherence tomography angiography (OCTA). (2) Methods: Thirty children with CHF due to DCM lasting more than six months, with an enlarged left ventricle and impaired left ventricular systolic function (left ventricular ejection fraction (LVEF) ≤ 55%), were enrolled to have both their eyes assessed for this study. Mean age of the children was 9.9 ± 3.57 years. The control group consisted of an additional 30 children without CHF (mean age 11.27 ± 3.33 years) matched for age and gender against the study group. All participants underwent transthoracic echocardiography to measure LVEF using Simpson method. Blood serum was tested for N-terminal-pro-brain natriuretic peptide (NT-proBNP) marker value. All children underwent OCTA with evaluation of the foveal avascular zone (FAZ), whole superficial vessel density (wsVD), foveal superficial vessel density (fsVD), parafoveal superficial vessel density (psVD), whole deep vessel density (wdVD), foveal deep vessel density (fdVD), parafoveal deep vessel density (pdVD), whole thickness (WT), foveal thickness (FT), and parafoveal thickness (PFT). (3) Results: Retinal VD in SP was significantly lower in children with CHF as compared to the controls. The following SP parameters in the study group were statistically significantly lower than these same measurements for the control group. Details, with study group findings quantified first, include wsVD (46.2% vs. 49.83%, p < 0.05), fsVD (18.07% vs. 24.15%, p < 0.05), and psVD (49.24% vs. 52.51%, p < 0.05). The WT (311.03 micrometers (μm) vs. 323.55 μm, p < 0.05), FT (244.57 μm vs. 256.98 μm, p < 0.05), and PFT (320.63 μm vs. 332.02 μm, p < 0.05). No significant differences in DP retinal VD were found between the two groups. No statistically significant differences in the FAZ were found. The fsVD and FT were correlated with biometry and the age of the study participants. There was a correlation between FAZ and FT (p < 0.001). There were no correlations between retinal VD in both plexuses and refractive error, sex, NT-proBNP, and LVEF. (4) Conclusions: In children with CHF in the course of DCM as compared to the control group, significantly decreased retinal VD in SP was observed. The results of our study indicate that measurements of the OCTA may be a useful diagnostic method in children with chronic heart failure, but it is necessary to conduct further studies in larger groups of participants and long-term observation of these patients.

scholarly journals Quantitative Analysis of Retinal Microvascular Changes in Optical Coherence Tomography Angiography Of Diabetic Retinopathy

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Prettyla Yollamanda ◽  
Arief Kartasasmita ◽  
Iwan Sovani ◽  
Erwin Iskandar ◽  
Rova Virgana ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Modality ◽  
Foveal Avascular Zone ◽  
Control Group ◽  
Optical Coherence ◽  
Non Invasive ◽  
Microvascular Changes

Introduction: Diabetic Retinopathy (DR) is a common microvascular complication in patients with Diabetes Mellitus (DM) that can cause visual impairment and blindness in adult populations. Retinal microvascular changes, reflecting capillary drop out, non perfusion, and retinal ischemia seen in patients with DM can be assessed not only qualitatively, but also quantitatively with the introduction of a new, non invasive imaging modality Optical Coherence Tomography Angiography (OCTA), avoiding potential advese risks that can occur with the use of dye-injection imaging technique. We quantified retinal microvascular changes in healthy control eyes and Diabetic Retinopathy using OCTA. Methods: A cross sectional study included 13 eyes of 9 patients with DR, consists of 11 eyes with Non Proliferative Diabetic Retinopathy (NPDR) and 2 eyes with Proliferative Diabetic Retinopathy (PDR) and 5 eyes of 5 age-matched controls. Participants were imaged with commercial OCTA device (CIRRUS HD-OCT 5000 Angioplex). We analyzed in the Superficial Capillary Plexus (SCP) the following OCTA parameters : Vessel Density (VD), Foveal Avascular Zone (FAZ) area, and FAZ circularity. Result: Normal eyes had a higher mean VD, FAZ circularity (p >0.05) and lower mean FAZ area ( p <0.05) in the SCP compared with the DR (NPDR + PDR) group. If we excluded the PDR eyes from the analytic data, mean VD and FAZ area were found to be lower in control group, and mean FAZ circularity was higher. However, no quantitative parameters were statistically significant between control group and NPDR group. Conclusion: Microvascular changes in DR can be assessed with the use of Optical Coherence Tomography Angioraphy, which is non invasive and provides high quality of images acquired from the chosen level of retina.

scholarly journals Factors predicting final visual outcome in quiescent proliferative diabetic retinopathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jinsoo Kim ◽  
In Won Park ◽  
Soonil Kwon
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Diabetic Foot ◽  
Smoking Status ◽  
Visual Outcome ◽  
Retinal Vessel ◽  
Foveal Avascular Zone ◽  
Panretinal Photocoagulation ◽  
Poor Visual Outcome ◽  
Capillary Plexus

Abstract To investigate factors reflecting visual outcome and macular perfusion in quiescent proliferative diabetic retinopathy (PDR) patients after panretinal photocoagulation (PRP). We included 118 patients with quiescent PDR who had completed PRP. All participants had standardized interview to determine ocular history, smoking status, cardiovascular risk factors, and history of diabetic mellitus (DM). Foveal avascular zone (FAZ) area, retinal vessel density (VD) and vessel length density (VLD) were measured using optical coherence tomography angiography. VD was negatively correlated with hypertension, diabetic foot, HbA1c, and time after PRP (β =  − 0.181, P = 0.046; β =  − 0.231, P = 0.020; β =  − 0.244, P = 0.010; β =  − 0.278, P = 0.029). FAZ area of superficial capillary plexus and deep capillary plexus (DCP) was positively correlated with DM duration and diabetic foot (β = 0.178, P = 0.047; β = 0.293, P = 0.002; β = 0.252, P = 0.045; β = 0.304, P = 0.002). Macular perfusion state in patients with quiescent PDR was associated with diabetic foot, DM duration, HbA1c, and time after PRP. Of note, diabetic foot showed the strongest correlation with macular perfusion among various systemic factors. VLD, especially in DCP was associated with poor visual outcome.

scholarly journals Quantitative analysis and clinical application of iris circulation in ischemic retinal disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanwen Jia ◽  
Wenwen Xue ◽  
Xiaowei Tong ◽  
Yulan Wang ◽  
Lipu Cui ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Quantitative Analysis ◽  
Blood Circulation ◽  
Retinal Blood Flow ◽  
Trial Registration ◽  
Control Group ◽  
Clinical Value ◽  
Clinical Trial Registration ◽  
Healthy Control

Abstract Background To evaluate quantitative changes in iris blood circulation in patients with ischemic risk. Methods This observational case-control study included 79 patients with diabetic retinopathy (DR) and retinal vein occlusion (RVO). The RVO group included 21 patients; the monocular proliferative diabetic retinopathy (PDR) group included 19 patients; the nondiabetic retinopathy (NDR) group included 18 patients; and the healthy control group included 21 healthy controls. In the RVO group, we analyzed RVO affected eyes, RVO contralateral eyes, and healthy control eyes. We also compared eyes with PDR and contralateral eyes without PDR, patients with diabetes mellitus (DM) without DR, and healthy control eyes. The microvascular networks of the iris and retina were analyzed using optical coherence tomography angiography. The analysis included vessel area density (VAD) and vessel skeleton density (VSD) of iris and retina. Results In the RVO group, the VAD and VSD of iris in the affected eye were higher than those in contralateral and healthy control eyes, and the VAD and VSD of contralateral eyes were higher than those of healthy control eyes. The retinal blood flow of the RVO eyes was less than that of the contralateral and healthy control eyes, but there were no difference between the contralateral eyes and healthy control eyes. The VAD and VSD of iris in PDR were larger than nonproliferative diabetic retinopathy (NPDR) and the NPDR were larger than NDR. There were no differences between NDR and healthy control eyes. Also, there were no differences among the four groups with respect to retinal blood flow. Conclusions Compared with the retina, iris blood circulation quantitative analysis data seem to be more sensitive to ischemia and may be used as a new predictor of ischemic disease, even if further research is needed to better understand the clinical value and importance of this analysis. Trial registration The trial is registered with the clinical trial registration number nct03631108.

scholarly journals Increased number of retinal vessels in acromegaly

2020 ◽  
Vol 182 (3) ◽  
pp. 293-302
Author(s):  
Laila Füchtbauer ◽  
Daniel S Olsson ◽  
Eva C Coopmans ◽  
Bengt-Åke Bengtsson ◽  
Lise-Lott Norrman ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Vessel ◽  
Diabetic Patients ◽  
Retinal Vessels ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Vessel Morphology ◽  
Increased Risk ◽  
Branching Points ◽  
Angiogenic Effect

Objective Excess of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), as in acromegaly, is associated with increased risk of diabetes, but whether retinal vessels are altered is unknown. The aim of this study was to evaluate retinal vessel morphology in patients with acromegaly at diagnosis and after treatment and to describe the prevalence of diabetic retinopathy in patients with long-standing acromegaly and diabetes. Design Two independent observational studies, one being prospective and the other retrospective and cross-sectional. Methods Retinal vessel morphology of 26 patients with acromegaly was examined at diagnosis and 1 year after treatment and compared to 13 healthy controls. Cross-sectional evaluation of 39 patients with long-standing acromegaly and diabetes was performed. Fundus photographs were digitally analyzed for vessel morphology. Results Patients with acromegaly had a median (interquartile range) of 34.3 (30.0–39.0) vessel branching points compared to 27.0 (24.0–29.0) for healthy controls (P < 0.001). Tortuosity of arterioles and venules remained unchanged. Vessel morphology did not change significantly after treatment. Patients with acromegaly and diabetes for a median of 14 years also had a high number of branching points (34.2 (32.5–35.6)), but the prevalence of diabetic retinopathy was not higher than expected in diabetic patients without acromegaly. Conclusions Patients with acromegaly have an increased number of vascular branching points in the retina without an alteration of macroscopic vessel morphology. This is consistent with an angiogenic effect of GH/IGF-1 in humans. The prevalence of diabetic retinopathy was not increased in patients with acromegaly and diabetes.

scholarly journals Optical Coherence Tomography Angiography Metrics Monitor Severity Progression of Diabetic Retinopathy—3-Year Longitudinal Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2296
Author(s):  
Inês P. Marques ◽  
Sophie Kubach ◽  
Torcato Santos ◽  
Luís Mendes ◽  
Maria H. Madeira ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Retinal Vessel ◽  
Vessel Density ◽  
Clear Correlation ◽  
Supporting Evidence ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Vessel Closure ◽  
Prospective Longitudinal

To examine retinal vessel closure metrics and neurodegenerative changes occurring in the initial stages of nonproliferative diabetic retinopathy (NPDR) and severity progression in a three-year period. Methods: Three-year prospective longitudinal observational cohort of individuals with type 2 diabetes (T2D), one eye per person, using spectral domain-optical coherence tomography (SD-OCT) and OCT-Angiography (OCTA). Eyes were examined four times with one-year intervals. OCTA vessel density maps of the retina were used to quantify vessel closure. Thickness of the ganglion cell + inner plexiform layer (GCL + IPL) was examined to identify retinal neurodegenerative changes. Diabetic retinopathy ETDRS classification was performed using the seven-field ETDRS protocol. Results: A total of 78 eyes/patients, aged 52 to 80 years, with T2D and ETDRS grades from 10 to 47 were followed for 3 years with annual examinations. A progressive increase in retinal vessel closure was observed. Vessel density (VD) showed higher decreases with retinopathy worsening demonstrated by step-changes in ETDRS severity scale (p < 0.001). No clear correlation was observed between neurodegenerative changes and retinopathy progression. Conclusions: Retinal vessel closure in NPDR correlates with DR severity progression. Our findings provide supporting evidence that OCTA metrics of vessel closure may be used as a surrogate for DR severity progression.

scholarly journals Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kiyoung Kim ◽  
Eung Suk Kim ◽  
Seung-Young Yu
Keyword(s):  
Diabetic Retinopathy ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Panretinal Photocoagulation ◽  
Swept Source ◽  
Retinal Microvasculature ◽  
En Face ◽  
Capillary Plexus ◽  
Swept Source Oct ◽  
Swept Source Oct Angiography

AbstractThis study evaluated quantitative changes in microvascular parameters after panretinal photocoagulation (PRP) in diabetic retinopathy (DR), using swept-source OCT Angiography (SS-OCTA). A total of 27 treatment-naïve eyes were subjected to PRP and followed-up for > 12 months after the procedure. Foveal avascular zone (FAZ) area, macular perfusion density (PD), and vessel length density (VLD) were calculated on a 3 × 3 mm en face OCTA image and nonperfusion area (NPA) was obtained on a 12 × 12 mm en face OCTA image. One month after PRP, PD and VLD of superficial and deep capillary plexus decreased and subsequently, increased progressively across the next 12 months, with statistically significant differences (P = 0.015 and 0.02). Continuous decreasing trends in total NPA values was observed across 12 months after PRP (P = 0.125). A difference in PD of the superficial capillary plexus between baseline and 6 months post PRP, was significantly associated with the progression of DR, 12 months after PRP (OR 0.528; P = 0.025). We found significant longitudinal retinal microvascular changes after PRP in DR. Overall macular perfusion status was impaired and progressively recovered across the next 12 months, compared to the baseline. Additionally, the early treatment responses in PD can predict the long-term outcomes of PDR after PRP.

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