Retinal and Choriocapillary Vascular Changes in Early Stages of Multiple Sclerosis: A Prospective Study

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.

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The Difference in Repeatability of Automated Superficial Retinal Vessel Density according to the Measurement Area Using OCT Angiography

Journal of Ophthalmology ◽

10.1155/2020/5686894 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Hyung Bin Lim ◽

Tae Seen Kang ◽

Yeo Kyoung Won ◽

Jung Yeul Kim

Keyword(s):

Intraclass Correlation ◽

Retinal Vessel ◽

Vessel Density ◽

Foveal Avascular Zone ◽

Capillary Plexus ◽

The Difference ◽

Retinal Vessel Density ◽

Perfusion Density ◽

Measurement Area ◽

Central Fovea

Purpose. To evaluate the difference in the repeatability of automated superficial retinal vessel density and foveal avascular zone (FAZ) metrics according to the measurement area of optical coherence tomography angiography (OCTA). Methods. A total of 127 normal eyes from 127 healthy subjects were included. Macular angiography images were acquired from all subjects using the Zeiss Cirrus 5000 with AngioPlex™ OCTA software. Scans of 3 × 3 mm and 6 × 6 mm were each performed twice in a randomly arranged sequence. Vessel density (VD), perfusion density (PD), and FAZ metrics of the superficial capillary plexus were calculated automatically for all scans, and the repeatabilities for both scan patterns were assessed based on intraclass correlation (ICC), coefficient of variation (CV), and coefficient of repeatability (CR) parameters. The average measured values in the two scan patterns were also compared. Results. VD was significantly greater in the 3 × 3 mm scan than in the 6 × 6 mm scan according to all parameters, whereas PD was significantly less in the 3 × 3 mm scan than in the 6 × 6 mm scan. The ICCs for VDs in the central fovea were 0.826 and 0.741 for the 3 × 3 and 6 × 6 mm scans, respectively, and the CVs were 8.00% and 12.75%. For PDs, the ICCs were 0.839 and 0.762 and the CVs were 9.32% and 14.90%. The FAZ metrics in the 3 × 3 mm scan showed good repeatability with an ICC >0.75 and a CV <10.0%. However, all ICCs for the 6 × 6 mm scans were <0.75, and the CVs were all >10%. Conclusions. The 6 × 6 mm macular angiography scans resulted in lower repeatabilities than the 3 × 3 mm scans according to all OCTA parameters, particularly in the central fovea and FAZ metrics. The 3 × 3 mm scan was more suitable than the 6 × 6 mm scan for analyzing macular microvascular density and FAZ metrics.

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Quantification of Optical Coherence Tomography Angiography in Age and Age-related Macular Degeneration using Vessel Density analysis

10.1101/19003053 ◽

2019 ◽

Author(s):

Ehsan Vaghefi ◽

Sophie Hill ◽

Hannah M Kersten ◽

David Squirrell

Keyword(s):

Optical Coherence Tomography ◽

Macular Degeneration ◽

Optical Coherence Tomography Angiography ◽

Retinal Vessel ◽

Vessel Density ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Age Related ◽

Capillary Plexus ◽

Retinal Vessel Density

AbstractPurposeTo determine whether vessel density (VD) as measured by optical coherence tomography angiography (OCT-A) provide insights into retinal and choriocapillaris vascular changes with ageing and intermediate dry age related macular degeneration (AMD).MethodsSeventy-five participants were recruited into three cohorts; young healthy (YH) group, old healthy (OH) and those at high-risk for exudative AMD. Raw OCT and OCT-A data from TOPCON DRI OCT Triton were exported using Topcon IMAGENET 6.0 software, and 3D datasets were analysed to determine retinal thickness and vessel density.ResultsCentral macular thickness measurements revealed a trend of overall retinal thinning with increasing age. VD through the full thickness of the retina was highest in ETDRS sector 4 (the inferior macula) in all the cohorts. Mean VD was significantly higher in the deep capillary plexus than the superficial capillary plexus in all ETDRS sectors in all cohorts but there was no significant difference noted between groups. Choriocapillaris VD was significantly lower in all ETDRS sectors in the in the AMD group compared with the YH and the OH groups.ConclusionsRetinal vessel density maps, derived from the retinal plexi are not reliable biomarkers for assessing the ageing macular. Our non-proprietary analysis of the vascular density of the choriocapillaris revealed a significant drop off of VD with age and disease but further work is required to corroborate this finding. If repeatable, choriocapillaris VD may provide a non-invasive biomarker of healthy ageing and disease.Brief SummaryIn this manuscript, we have studied the potential of retinal vessel density as measured by optical coherence tomography angiography (OCT-A), as a biomarker for detection of high-risk of developing exudative age-related macular degeneration (AMD).

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Reproducibility of high-resolution optical coherence tomography in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458510371640 ◽

2010 ◽

Vol 16 (7) ◽

pp. 829-839 ◽

Cited By ~ 57

Author(s):

Stephanie B Syc ◽

Christina V Warner ◽

Girish S Hiremath ◽

Sheena K Farrell ◽

John N Ratchford ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Intraclass Correlation ◽

Healthy Controls ◽

Optical Coherence ◽

High Definition ◽

Fiber Layer ◽

Multiple Sclerosis Patients ◽

A Prospective Study ◽

Sd Oct

Optical coherence tomography (OCT) is a non-invasive method to quantify neurodegeneration as an outcome in multiple sclerosis clinical trials; however, no data exist on Cirrus spectral domain optical coherence tomography (SD-OCT) reproducibility in patients with multiple sclerosis. The objective of this study was to determine the protocol for achieving optimal inter-visit, inter-rater, and intra-rater reproducibility for studies performed on healthy controls and multiple sclerosis patients utilizing novel high-definition SD-OCT. This is a prospective study of inter-visit, inter-rater, and intra-rater reproducibility in multiple sclerosis patients ( n = 58) and healthy controls ( n = 32) on Cirrus-HD SD-OCT. Excellent reproducibility of average and quadrantic retinal nerve fiber layer (RNFL) thickness values, average macular thickness (AMT), and total macular volume (TMV) [measured by intraclass correlation coefficient (ICC)] was found for inter-visit (healthy controls: mean RNFL = 0.97, quadrant range = 0.92—0.97, AMT = 0.97, TMV = 0.92), inter-rater (MS: mean RNFL = 0.97, quadrant = 0.94—0.98, AMT = 0.99, TMV = 0.96; healthy controls: mean RNFL = 0.97, quadrant = 0.94—0.97, AMT = 0.98, TMV = 0.99), and intra-rater (MS patients: mean RNFL = 0.99, quadrant = 0.83—0.99, AMT = 0.97, TMV = 0.98) reproducibility. The reproducibility of retinal measures derived by Cirrus HD-OCT, especially quadrantic values, is excellent. Specific procedures for OCT acquisition and analysis of retinal imaging metrics using SD-OCT technology may improve the application of this novel technology in multiple sclerosis.

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

Journal of Clinical Medicine ◽

10.3390/jcm10122659 ◽

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.

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Evaluation of the correlation between quantitative measurement of the foveal avascular zone and retinal vessel density and outer retinal disruptions in diabetic patients.

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-1901-22 ◽

2019 ◽

Cited By ~ 1

Author(s):

NAGİHAN UĞURLU ◽

AYŞE GÜZİN TAŞLIPINAR UZEL ◽

AHMET ŞENGÜN ◽

FATMA YÜLEK ◽

DEMET ÖZDAŞ ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Retinal Vessel ◽

Vessel Density ◽

Foveal Avascular Zone ◽

Diabetic Patients ◽

Optical Coherence ◽

Retinal Layers ◽

Avascular Zone ◽

Capillary Plexus ◽

Retinal Vessel Density

Aim: The aim of the current study was to evaluate the correlation between the integrity of the outer retinal layers on optical coherence tomography (OCT) and objective parameters of retinal microvascular perfusion on optical coherence tomography angiography (OCTA). Method: 105 eyes of 54 diabetic patients were included in to the study. Integrity of the outer retinal layers including the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) were assessed by spectral-domain optical coherence tomography (SD-OCT). The foveal avascular zone (FAZ) area and vessel density (VD) measurements in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in all the Early Treatment Diabetic Retinopathy Study (ETDRS) sectors were evaluated by OCTA. Association between the quantitative measurement of the foveal avascular zone and retinal vessel density measurements and outer retinal disruptions were evaluated. Results: FAZ area was correlated with outer retinal layer disruption at both in the superficial plexus (r = 0.244, 0.228, 0.212, p = 0.013, 0.02, 0.031 for the ELM, EZ and IZ respectively) and deep capillary plexus (r = 0.298, 0.234, 0.197, p = 0.002, 0.019, 0.048 for the ELM, EZ and IZ respectively). A significant relationship was also found between the VD measurements in the SCP and DCP in ETDRS sectors and the outer retinal layers disruption. Conclusion: The result of the current study shows a significant relationship between the quantitative OCTA parameters and the integrity of the outer retinal layers and. This finding reveals a correlation between retinal capillary nonperfusion and outer retinal disruption in eyes with diabetic retinopathy. Key Words: Outer retinal disruption, external limiting membrane, ellipsoid zone, interdigitation zone, foveal avascular zone, superficial capillary plexus, deep capillary plexus, optical coherence tomography angiography

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Differentiation between multiple sclerosis and neuromyelitis optica spectrum disorder using optical coherence tomography angiography

Scientific Reports ◽

10.1038/s41598-021-90036-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Małgorzata Rogaczewska ◽

Sławomir Michalak ◽

Marcin Stopa

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Neuromyelitis Optica ◽

Vessel Density ◽

Spectrum Disorder ◽

Demyelinating Diseases ◽

Ganglion Cell Complex ◽

Optical Coherence ◽

Neuromyelitis Optica Spectrum Disorder ◽

Fiber Layer

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.

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The Retinal Vessel Density as a New Vascular Biomarker in Multisystem Involvement in Fabry Disease: An Optical Coherence Tomography Angiography Study

Journal of Clinical Medicine ◽

10.3390/jcm9124087 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4087

Author(s):

Gilda Cennamo ◽

Daniela Montorio ◽

Ciro Santoro ◽

Sirio Cocozza ◽

Letizia Spinelli ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Fabry Disease ◽

Optical Coherence Tomography Angiography ◽

Global Longitudinal Strain ◽

Retinal Vessel ◽

Vessel Density ◽

Volume Index ◽

Optical Coherence ◽

Capillary Plexus ◽

Retinal Vessel Density

In this study, we evaluated the possible relationship between the changes in retinal vessel density (VD) by optical coherence tomography angiography (OCTA) and the vascular alterations involving renal, cardiovascular and central nervous systems in patients affected by Fabry disease (FD). In 50 FD patients, the retinal superficial capillary plexus (SCP) and deep capillary plexus (DCP) in macular region were evaluated by OCTA examination. The patients also underwent a brain magnetic resonance imaging scan, renal and echocardiographic examinations with quantification of systolic pulmonary arterial pressure (PAPs) and left atrial volume index (LAVi). The VD of SCP and DCP was inversely related with E/e’ ratio, LAVi, interventricular septal thickness, global longitudinal strain (GLS) and PAPs (p < 0.05). No relationship was found, with a multivariate analysis, between OCTA parameters and kidney function and neuroradiological signs of central nervous system involvement. OCTA could be a new vascular biomarker in FD, revealing a strong correlation between retinal capillary damage and myocardial impairment, possibly preceding both renal dysfunction and cerebrovascular involvement.

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Vessel Density and Structural Measurements in Primary Angle-Closure Suspect Glaucoma Using Optical Coherence Tomography Angiography

BioMed Research International ◽

10.1155/2020/7526185 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Yi Zha ◽

Juanjuan Chen ◽

Shuyu Liu ◽

Jinfei Zhuang ◽

Jianqiu Cai

Keyword(s):

Retinal Vessel ◽

Normal Subjects ◽

Vessel Density ◽

Angle Closure ◽

Control Group ◽

Fiber Layer ◽

Primary Angle Closure ◽

Rnfl Thickness ◽

Significant Difference ◽

Retinal Vessel Density

Purpose. To measure the macular retinal vessel density (VD) and peripapillary retinal nerve fiber layer (RNFL) in primary angle-closure suspects (PACS) by Angio-OCT to be compared with normal subjects. Methods. Primary angle-closure suspect patients and normal subjects were enrolled in this study. The demographic and clinical characteristics of all subjects, such as RNFL thickness, retinal vessel density, and ocular perfusion pressure, were compared. Results. No significant difference was found in both groups on age, sex distribution, intraocular pressure (IOP), and retinal vessel density. The PACS group exhibited significantly thicker RNFL thickness compared with the control group. The deep vessel density was negatively associated with age ( P = − 0.034 ), while IOP had negative association with ACD ( P = − 0.019 ). OPP was independently associated with RNFL ( B = 0.334 , P = 0.038 ) in the PACS group. Conclusions. OCTA showed significant thicker change on RNFL in the PACS group. Only OPP was independently associated with RNFL in the PACS group.

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Identification of imaging features that determine quality and repeatability of retinal capillary plexus density measurements in OCT angiography

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310700 ◽

2017 ◽

Vol 102 (4) ◽

pp. 509-514 ◽

Cited By ~ 25

Author(s):

Beau J Fenner ◽

Gavin S W Tan ◽

Anna C S Tan ◽

Ian Y S Yeo ◽

Tien Yin Wong ◽

...

Keyword(s):

Imaging System ◽

Intraclass Correlation ◽

Density Measurement ◽

Retinal Vessel ◽

Vessel Density ◽

Imaging Features ◽

Density Measurements ◽

Retinal Capillary ◽

Capillary Plexus ◽

Retinal Vessel Density

PurposeOptical coherence tomography angiography (OCT-A) potentially allows for rapid and non-invasive quantification of retinal capillary plexus density in various disease states. This study aims to identify the key features that influenced the repeatability of OCT-A measurements.MethodsWe obtained OCT-A images on two separate visits in 44 healthy eyes from 44 subjects, each imaged with using the Topcon DRI OCT Triton imaging system. The parafoveal vessel density within a 1.5 mm radius centred over the fovea was obtained with the built-in tool for the superficial and deep retinal plexuses. Repeatability of vessel density was determined by intraclass correlation (ICC) and mean variation. We evaluated several image parameters to determine their influence on the repeatability of vessel density measurement in each of the two capillary plexuses.ResultsThe mean age of the subjects was 70.2±9.2 years, with 64% males. Mean parafoveal vessel density measurements for the first and second visits were 53.3±11.1 and 53.3±10.3 for the superficial plexus and 27.3±8.59 and 27.0±8.78 for the deep plexus. ICC analyses demonstrated that high fine vessel visibility, the absence of motion artefact and software-derived image quality score of 60 or above were necessary to obtain a good (ICC>0.6) or excellent (ICC>0.75) repeatability.ConclusionsOur study identified the imaging parameters that determined the repeatability of quantitative retinal vessel density measurements. These findings have implications in determining if OCT-A images can be used to accurately evaluate serial changes in retinal vessel density.

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

Diagnostics ◽

10.3390/diagnostics11050802 ◽

2021 ◽

Vol 11 (5) ◽

pp. 802

Author(s):

Marco Capece ◽

Daniela Montorio ◽

Chiara Comune ◽

Achille Aveta ◽

Alberto Melchionna ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optic Disc ◽

Vessel Density ◽

Matched Pair ◽

Ganglion Cell Complex ◽

Optical Coherence ◽

Vascular Changes ◽

Fiber Layer ◽

Capillary Plexus

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.

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