scholarly journals Retinal and Optic Disc Vascular Changes in Patients Using Long-Term Tadalafil: A Prospective Non-Randomized Matched-Pair Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 802
Author(s):  
Marco Capece ◽  
Daniela Montorio ◽  
Chiara Comune ◽  
Achille Aveta ◽  
Alberto Melchionna ◽  
...  

Retinal, choroidal and optic disc vascularity has never been evaluated in patients taking PDE5is long-term. The aim of our study was to evaluate the neurostructural and vascular changes after long-term use of tadalafil, using spectral domain (SD)-optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In the present clinical trial, 27 patients who have been taking tadalafil 20 mg on alternate days (OAD) for at least 6 months (Group A) were enrolled. The matched group consisted of 27 healthy men (Group B). Both groups of patients underwent SD-OCT to study ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) and choroidal thickness and OCTA for the evaluation of superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and radial peripapillary capillary (RPC). A reduction in SCP, DCP and RPC vessel density was found in patients using tadalafil long-term. Retinal and optic disc toxicity may be detected using modifications of capillary vessel density. Further studies are needed to investigate the possibility of a causal association.

2020 ◽  
Vol 9 (3) ◽  
pp. 697 ◽  
Author(s):  
Ga-In Lee ◽  
Kyung-Ah Park ◽  
Sei Yeul Oh ◽  
Doo-Sik Kong

Background: To evaluate the potential of vessel density alterations for predicting postoperative visual field (VF) improvement in chiasmal compression using optical coherence tomography angiography (OCT-A). Methods: The study investigated 57 eyes of 57 patients diagnosed with pituitary tumors and 42 eyes of 42 age and refractive error matched controls. All eyes with chiasmal compression for which preoperative optical coherence tomography (OCT) and OCT-A, and pre- and postoperative VF data were available. Preoperative vessel densities of superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment were utilized by OCT-A. Results: Preoperative peripapillary retinal nerve fiber layer and ganglion cell layer complex thickness and vessel densities of SRCP and RPC segments in eyes with chiasmal compression were significantly reduced compared with healthy controls (p < 0.001, p < 0.001, p = 0.007, and p = 0.020, respectively). In multivariate regression analysis, preoperative perimetric mean deviation (MD) (p = 0.002) and vessel density of SRCP (p = 0.025) were correlated significantly with postoperative perimetric MD. Spearman’s correlation analysis revealed significant correlations between preoperative MD on perimetry (r = 0.443, p = 0.001), vessel densities of SRCP (r = 0.288, p = 0.035) and RPC segment (r = 0.347, p = 0.009), and postoperative perimetric MD. Conclusions: Structural degeneration referred to as microvascular alterations measured by OCT-A and preoperative VF defects were associated with worse postoperative VF prognosis. Parafoveal and peripapillary vessel densities may serve as a sensitive, structural prognostic factors in the preoperative judgement of chiasmal compression.


2020 ◽  
Author(s):  
Xiaoxiao Chen ◽  
Xiaolei Wang ◽  
Xinxin Hu ◽  
Xinghuai Sun

Abstract Background: We wish to evaluate the vessel density using optical coherence tomography angiography (OCTA) in juvenile ocular hypertension (JOHT). In addition, we investigate the potential risk parameters of intraocular pressure (IOP) and vertical cup/disc ratio (CDR) with OCTA for observing the development of JOHT. Methods: We examined 86 eyes in 45 healthy subjects and 65 eyes in 34 patients with JOHT using OCTA at the glaucoma clinic of the Eye, Nose, and Throat Hospital of Fudan University. The vessel density (VD) of radial peripapillary capillaries (RPC) and perifoveal superficial vascular plexus (SVP) was compared between healthy and JOHT group. Other basic study factors such as: age, sex, blood pressure, best-corrected visual acuity, central corneal thickness, IOP, CDR, the thickness of retinal nerve fiber layer, ganglion cell complex, visual field mean deviation, and pattern standard deviation were also recorded. Results: Temporal RPC-VD was negatively associated with IOP (p=0.043). Additional five sections of nasal, inferior-nasal, inferior-temporal, superior-temporal and superior-nasal of RPC-VD showed positive correlation with CDR. SVP-VD in superior and nasal regions were affected by high IOP (p=0.023 and p=0.049). No other difference was uncovered between healthy and JOHT subjects. Conclusions: Peripapillary temporal perfusion had negative correlation with IOP in JOHT subjects. And regions were positively correlated with large CDR. Perfusion of perifoveal regions were only affected by IOP. We conclude that OCTA could be used as an effective technique to monitor the development of JOHT.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lu Xiang ◽  
Yingming Zhou ◽  
Yanwei Chen ◽  
Siyu Jiang ◽  
Chunli Fei ◽  
...  

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Małgorzata Rogaczewska ◽  
Sławomir Michalak ◽  
Marcin Stopa

AbstractNeuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are autoimmune demyelinating diseases of distinct etiology presenting with optic neuritis (ON). This study aimed to identify the macular and peripapillary neurovascular alterations that may facilitate the differentiation between NMOSD and MS eyes using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA). A total of 13 NMOSD patients and 40 MS patients were evaluated. After ON, the radial peripapillary capillary (RPC) vessel density was significantly decreased in the superior (S) and inferior (I) sectors in NMOSD compared with MS eyes, whereas in non-ON eyes, the temporal (T) sector of RPC was reduced in MS group. In the ON eyes, the retinal nerve fiber layer in the I and T quadrants was thinner in NMOSD than in MS. Regarding ON and non-ON eyes, the macular capillary plexuses, and the ganglion cell complex thickness did not differ between NMOSD and MS. The ratios, based on the disease-specific intra-eye RPC vessel density reduction pattern, were the best discriminants between NMOSD and MS, i.e., inferior to nasal (I/N) and I/T ratios for ON eyes, and S/T and N/T ratios for non-ON eyes. Our results show that the OCTA-based simple ratios may be useful in distinguishing NMOSD and MS patients.


2021 ◽  
Vol 8 ◽  
Author(s):  
Tian Huang ◽  
Xiaoli Li ◽  
Jie Xie ◽  
Liang Zhang ◽  
Guanrong Zhang ◽  
...  

Purpose: To evaluate the long-term retinal microvascular, neural, and choroidal changes in the patients with severe nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP).Methods: Forty-five eyes of 28 patients with treatment-naive severe NPDR and PDR were included and followed for 12 months after PRP. Microvascular and neural changes in the macular and peripapillary areas were assessed by using optical coherence tomography angiography. Subfoveal choroidal thickness (SFCT) was measured by using optical coherence tomography. A Linear mixed-effects model was used to highlight the differences for the variables after adjusting for sex, age, and axial length.Results: Compared to baseline, there were no statistical differences in the best corrected visual acuity (BCVA), macular and peripapillary vessel density (VD), and SFCT following PRP. Macular thickness significantly increased at 1 and 3–6 months after PRP (p &lt; 0.05), while the peripapillary retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness significantly increased at 1 month postoperatively (p &lt; 0.01). Global loss volume and focal loss volume significantly decreased at the same time point (p &lt; 0.05).Conclusion: The unchanged BCVA, VD, the thickness of RNFL and GCC, and SFCT during the 12-month follow-up period suggest that PRP may prevent the retinal neurovascular and choroidal damage.


2021 ◽  
Vol 10 (24) ◽  
pp. 5756
Author(s):  
Daniela Montorio ◽  
Roberta Lanzillo ◽  
Antonio Carotenuto ◽  
Maria Petracca ◽  
Marcello Moccia ◽  
...  

Optical Coherence Tomography Angiography (OCTA) abnormalities occur in multiple sclerosis (MS) over the course of the disease. OCTA investigations at early MS stages are lacking. We aimed to investigate vessel density in macular and papillary regions over two years after an initial demyelinating event (IDE). Vessel density was analyzed in superficial, deep, choriocapillaris and radial peripapillary plexus at baseline, and after one and two years. We also evaluated structural OCT parameter changes of the ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). We evaluated 30 eyes from 15 IDE patients (7 females, 8 males, mean age 28.4 ± 9.6 years) and 30 eyes from 15 healthy controls. After 2 years, we reported in the IDE group a reduced vessel density in the superficial capillary plexus, deep capillary plexus and radial peripapillary capillary plexus with respect to the baseline (coeff. β = −2.779, p = 0.013; coeff. β = −4.055, p = 0.018 and coeff. β = −2.687, p ≤ 0.001; respectively), while GCC and RNFL thicknesses did not change. Vessel density reduction was not associated with an expanded disability status scale (EDSS) change, relapse occurrence or magnetic resonance imaging activity. The analysis of healthy controls did not reveal any impairment in OCT and OCTA parameters over 2 years of follow-up. Retinal vascular loss occurs in patients with an IDE independently from clinical and radiological disease activity. Retinal vessel density could represent a novel early biomarker to monitor the MS pathological burden.


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.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Youxin Chen

The aim of this study was to compare the repeatability of optical coherence tomography angiography (OCT-A) measurements of macular vessel density using four OCT-A systems, including Heidelberg Spectralis HRA, Optovue RTVue XR, Zeiss Cirrus HD-OCT 5000, and Topcon DRI OCT Triton. A cross-sectional design was used for this study. The vascular density and vascular length density of the superficial and deep retinal capillary plexuses were imaged with OCT-A using 3 mm and 6 mm scan patterns and were calculated using ImageJ. Comparisons of intraclass correlation coefficients (ICC) were conducted. We found that the OCT-A systems had various levels of repeatability. Zeiss had better repeatability for vessel density than the other systems (overall ICC = 0.936). Optovue had better repeatability for vessel length density when the 6 mm scan pattern was used (ICC = 0.680 and 0.700 for retinal superficial and deep capillary plexus, respectively). We concluded that repeatability varied when different scan patterns of various OCT-A systems were used for imaging the superficial retinal and deep capillary plexuses. Results should be seen as valid only for a given method. The repeatability of various OCT-A systems should be considered in clinical practice and in clinical trials that use OCT-A metrics as outcome measures.


2019 ◽  
Vol 8 (12) ◽  
pp. 2067 ◽  
Author(s):  
Rodolfo Mastropasqua ◽  
Rossella D’Aloisio ◽  
Pasquale Viggiano ◽  
Enrico Borrelli ◽  
Carla Iafigliola ◽  
...  

(1) Background: The aim of this observational cross-sectional work was to investigate early retinal vascular changes in patients undergoing idiopathic epiretinal membrane (iERM) surgery using swept source optical coherence tomography angiography (SS-OCTA); (2) Methods: 24 eyes of 24 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling were evaluated pre- and postoperatively using SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 6x6-mm OCTA volume scans were acquired by two observers independently. The en face images of superficial capillary plexus (SCP) were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. Perfusion density (PD), vessel length density (VLD), vessel diameter index (VDI) and vessel tortuosity (VT) of SCP were evaluated in both the parafoveal (2.5 mm diameter) and perifoveal areas (5.5 mm diameter); (3) Results: At OCTA analysis statistically significant differences were found between controls and diseased eyes for all parameters in parafoveal and perifoveal regions (p < 0.001; p < 0.05) except for perifoveal VLD. During 6-month follow up, both anatomical/perfusion and functional parameters showed a statistically significant improvement if compared to preoperative values. In detail, at one-month post vitrectomy, VLD and VT significantly changed in parafoveal region (p = 0.043; p = 0.045), while PD and VDI showed a trend of increase in both parafoveal and perifoveal region. At 6 months after surgery, PD, VLD and VT of parafoveal region significantly improved (p = 0.021, p = 0.018, p = 0.047 respectively). (4) Conclusions: SS-OCTA provides a quantitative and qualitative analysis of the superficial capillary plexus allowing for early vascular changes assessment after vitrectomy with iERM and ILM peeling.


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