Effects of the hand-grip test on retinal vascular and structural parameters measured by optical coherence tomography in healthy subjects

2020 ◽  
Vol 2 (4) ◽  
pp. 55-66
Author(s):  
Carlo Alberto Cutolo ◽  
Alice Chandra Verticchio Vercellin ◽  
Lorenzo Ferro Desideri ◽  
Chiara Bonzano ◽  
Felice Cardillo Piccolino ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Optical Coherence Tomography ◽  
Healthy Subjects ◽  
Structural Parameters ◽  
Retinal Layer ◽  
Optical Coherence ◽  
Hand Grip ◽  
Randomized Clinical Study ◽  
Grip Test

Purpose: To examine the relationship between the cardiovascular status and variations in optical coherence tomography (OCT)-derived parameters of the peripapillary and macular tissues, and macular vascular flow area measured by optical coherence tomography angiography (OCTA) in healthy subjects. Design: Prospective, open-label, non-randomized clinical study. Methods: Twenty one eyes of 21 healthy subjects were analyzed using a swept-source device, including OCT and OCTA acquisitions. Cardiovascular changes were investigated by performing a practical hand-grip test (HGT). Blood pressure, heart rate, OCT and OCTA structural and vascular changes were measured and analyzed before and after the HGT-induced exercise. Results: The mean patient age was 34.0 (± 15.2) years. While both diastolic and systolic blood pressures increased significantly aft er exercise (p < 0.001 and p = 0.003, respectively), the heart rate did not show a significant increment (p = 0.182). OCT structural parameters of the optic nerve did not change significantly. Instead, a significant redistribution of choroidal thickness (CT) was observed in the macular region, with a significant reduction (-6.5%, p = 0.001) in the outer-nasal macular sector after exercise. OCTA acquisitions did not show changes in the vascular density of both the superficial retinal layer and deep retinal layer. Conclusions: We demonstrated that HGT-induced exercise can moderately elevate blood pressure without detectable effects on OCTA-derived parameters in healthy young subjects. Moreover, it produced a significant redistribution of CT. Further studies are needed to better explain the possible role of HGT in the characterization of the pathophysiology of ocular diseases associated with abnormalities of the vascular function such as glaucoma, age-related macular degeneration, and diabetic retinopathy.

scholarly journals Comparison of Superficial and Deep Foveal Avascular Zone Area in Healthy Subjects Using Two Spectral Domain Optical Coherence Tomography Angiography Devices

2020 ◽  
Author(s):  
Pasha Anvari ◽  
Amin Najafi ◽  
Reza Mirshahi ◽  
Mahsa Sardarinia ◽  
Maryam Ashrafkhorasani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Spectral Domain ◽  
Foveal Avascular Zone ◽  
Retinal Layer ◽  
Optical Coherence ◽  
Retinal Layers ◽  
Avascular Zone ◽  
The Mean

Purpose: To compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices. Methods: A cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared. Results: Twenty-three eyes of 23 subjects were included. The graders agreement was excellent (>0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 ± 0.08 mm2 vs 0.26 ± 0.08 mm2 in Optovue and 0.55 ± 0.16 mm2 vs 0.36 ± 0.13 mm2 in Spectralis, both P < 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P < 0.001 for both comparisons). Conclusion: In contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.

scholarly journals Study of Autonomic Functions in Cigarette Smokers

2015 ◽  
Vol 1 (7) ◽  
pp. 293
Author(s):  
Mohit Malge ◽  
K. Ranjith Babu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cigarette Smoking ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Autonomic Functions ◽  
Cigarette Smokers ◽  
Pressor Test ◽  
Hand Grip ◽  
Grip Test

Introduction: Smoking is one of the most ancient and widespread mans activities. The present study was chosen to determine sympathetic and parasympathetic activity in cigarette smokers and compare it with healthy age matched controls in order to find out what influence does smoking have on baroreceptor sympathetic and parasympathetic control mechanisms and to find out for any co-relation between duration of cigarette smoking and autonomic dysfunction.Materials & Methods: Fifty cigarette smokers and fifty normal, healthy, nonsmokers were selected as age matched controls to study autonomic functions. Sympathetic functions were carried out by Cold Pressor Response test and Hand Grip test. Parasympathetic functions were tested by Determination of Heart Rate with change in posture and Sinus Arrhythmia.Results: Smokers revealed more pronounced rise both in systolic as well as diastolic blood pressure as compared to normal healthy controls during cold pressor test. Smokers revealed more pronounced rise in both SBP and DBP as compared to nonsmokers during hand grip test. There was increased heart rate in initial 10 seconds when there is postural change i.e. lying down to standing in both the groups. There was an increase in heart rate during inspiration and decrease during expiration (sinus arrhythmia) both in smokers and healthy controls.Conclusion: Cigarette smoking affects cardiovascular functions as indicated by rise in blood pressure in smokers than nonsmokers reflects the sensitivity of sympathetic activity to nicotine due to smoking. Thus the study concludes that smoking possibly has an effect on neurocardiovascular regulation system altering the sensitivity of ANS activity in habitual smokers.Keywords: Autonomic Function Tests, Smokers, Non-smokers, Cold Pressor Test, Hand Grip Test, Heart Rate.

Cardiovascular Functional Disorder and Distress among Patients with Thoracic Outlet Syndrome

1995 ◽  
Vol 20 (1) ◽  
pp. 29-33 ◽  
Author(s):  
M. GOCKEL ◽  
H. LINDHOLM ◽  
M. VASTAMÄKI ◽  
A. LINDQVIST ◽  
A. VILJANEN
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Diastolic Blood Pressure ◽  
Thoracic Outlet Syndrome ◽  
Psychological Help ◽  
Valsalva Manoeuvre ◽  
Control Group ◽  
Orthostatic Test ◽  
Hand Grip ◽  
Grip Test

Cardiovascular functional stability of 11 women with thoracic outlet syndrome (TOS; mean age 34.5) and nine female controls (mean age 35.1) was studied using an orthostatic test, a deep breathing test, Valsalva manoeuvre and hand-grip test. The heart rate at rest was significantly higher in TOS patients. The TOS group showed significant accentuation in T wave vacillation in the orthostatic test. The rise in diastolic blood pressure of the TOS group during a hand-grip test was significantly less than that of the control group. TOS patients experienced significantly more distress according to the modified somatic perception questionnaire (MSPQ) than the control group. Pain was correlated with the score of MSPQ, the resting heart rate and increase in diastolic blood pressure in a hand-grip test. The results suggest that TOS patients’ symptoms often reflect a wider disturbance than merely anatomical compression in the thoracic outlet. It seems possible that sympathetic tone is higher in TOS patients than in controls. In addition to possible operative treatment, it may be necessary to provide psychological help, relaxation and endurance training.

Wide-field optical coherence tomography imaging in diabetic retinopathy

2021 ◽  
pp. 112067212110549
Author(s):  
Ilkay Kilic Muftuoglu ◽  
Gagan Kalra ◽  
Mohammed Abdul Rasheed ◽  
Carlo Cagini ◽  
Ramkailash Gujar ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Healthy Subjects ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Reference Points ◽  
Retinal Layer ◽  
Wide Field ◽  
Inner Plexiform Layer ◽  
Optical Coherence

Purpose To report the individual retinal layer thicknesses up to mid-equator in patients with diabetic retinopathy (DR) using Spectralis (Heidelberg Engineering, Heidelberg, Germany) wide-field optical coherence tomography (OCT). Methods Retinal layers were segmented using a custom designed semi-automated algorithm, where reference points were marked by the examiner to enable software to automatically compute the thickness values of each retinal sublayer at an interval of 1 mm from reference points. The values of individual retinal thicknesses in eyes with varying severity of DR were compared with the values of healthy subjects. Generalized estimating equation was performed to compensate for inclusion of both eyes of patients. Results A total of 64 patients (119 eyes) with a mean age of 68.97  ±  10.27 years were included. Overall, ganglion cell layer (GCL)/ inner plexiform layer (IPL) complex (-31.67 microns, p < 0.001), outer plexiform layer (-6.78 microns, p = 0.002) and photoreceptor layer (-22.90 microns, p < 0.001) showed significant thinning, while outer nuclear layer thickening ( + 68.19 microns, <0.001) was noted in eyes with DM compared to healthy subjects. Thickness changes were significantly more in the macular segment compared to nasal and temporal segments. GCL/ IPL complex and photoreceptor layers were found to be significantly thin in all grades of DR. Conclusion Retinal thicknesses vary significantly in patients with diabetic retinopathy and understanding patterns of these changes across different segments of the wide field OCT may help better elucidate the natural progression of the disease in terms of retinal anatomy.

Wide-field individual retinal layer thickness in healthy eyes

2020 ◽  
pp. 112067212092766
Author(s):  
Sumit Randhir Singh ◽  
Alessandro Invernizzi ◽  
Mohammed Abdul Rasheed ◽  
Carlo Cagini ◽  
Abhilash Goud ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Regression Analysis ◽  
Layer Thickness ◽  
Healthy Subjects ◽  
Retinal Thickness ◽  
Optic Disk ◽  
Retinal Layer ◽  
Wide Field ◽  
Optical Coherence ◽  
Healthy Eyes

Purpose To report the individual retinal layer thickness in healthy subjects using wide-field optical coherence tomography. Methods This was a prospective, cross-sectional study involving healthy subjects. A custom-designed semiautomated segmentation algorithm was used to split the retinal layers in seven bands, and individual retinal layer thicknesses were measured in horizontal (nasal, macular, and temporal segments) and vertical meridians (superior, macular, and inferior segments). The variation in retinal thickness was analyzed in different segments at an interval of 1 mm from reference points. Regression analysis was performed to identify the factors affecting retinal thickness. Results Twenty eyes of 20 healthy subjects with mean age of 28.9 ± 6.3 years were analyzed. Overall, nasal and superior segments (mean ± standard deviation: 279.6 ± 17.0 and 234.4 ± 19.2 µm) had maximum and minimum retinal thicknesses, respectively. A total of seven bands were delineated in each optical coherence tomography b scan in each segment. Retinal nerve fiber layer was thickest immediately nasal to optic disk margin in horizontal scan (72.4 ± 32.4 µm) and near the vascular arcades in vertical meridian. Outer plexiform layer, external limiting membrane–ellipsoid zone and interdigitation zone–retinal pigment epithelium–Bruch’s complex showed significant variation in both horizontal and vertical meridians (all p values <0.05). Macular segment in both meridians showed the highest coefficient of variation. Age was the only significant factor affecting retinal thickness in multiple regression analysis (p = 0.001). Conclusions Wide-field optical coherence tomography shows significant regional variation in overall and individual retinal layer thicknesses in macular and peripheral areas in healthy eyes with the highest variation in macular segment.

scholarly journals Foveal avascular zone segmentation in optical coherence tomography angiography images using a deep learning approach

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Reza Mirshahi ◽  
Pasha Anvari ◽  
Hamid Riazi-Esfahani ◽  
Mahsa Sardarinia ◽  
Masood Naseripour ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Deep Learning ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Validation Dataset ◽  
Diabetic Patients ◽  
Dice Similarity Coefficient ◽  
Optical Coherence ◽  
Avascular Zone

AbstractThe purpose of this study was to introduce a new deep learning (DL) model for segmentation of the fovea avascular zone (FAZ) in en face optical coherence tomography angiography (OCTA) and compare the results with those of the device’s built-in software and manual measurements in healthy subjects and diabetic patients. In this retrospective study, FAZ borders were delineated in the inner retinal slab of 3 × 3 enface OCTA images of 131 eyes of 88 diabetic patients and 32 eyes of 18 healthy subjects. To train a deep convolutional neural network (CNN) model, 126 enface OCTA images (104 eyes with diabetic retinopathy and 22 normal eyes) were used as training/validation dataset. Then, the accuracy of the model was evaluated using a dataset consisting of OCTA images of 10 normal eyes and 27 eyes with diabetic retinopathy. The CNN model was based on Detectron2, an open-source modular object detection library. In addition, automated FAZ measurements were conducted using the device’s built-in commercial software, and manual FAZ delineation was performed using ImageJ software. Bland–Altman analysis was used to show 95% limit of agreement (95% LoA) between different methods. The mean dice similarity coefficient of the DL model was 0.94 ± 0.04 in the testing dataset. There was excellent agreement between automated, DL model and manual measurements of FAZ in healthy subjects (95% LoA of − 0.005 to 0.026 mm2 between automated and manual measurement and 0.000 to 0.009 mm2 between DL and manual FAZ area). In diabetic eyes, the agreement between DL and manual measurements was excellent (95% LoA of − 0.063 to 0.095), however, there was a poor agreement between the automated and manual method (95% LoA of − 0.186 to 0.331). The presence of diabetic macular edema and intraretinal cysts at the fovea were associated with erroneous FAZ measurements by the device’s built-in software. In conclusion, the DL model showed an excellent accuracy in detection of FAZ border in enfaces OCTA images of both diabetic patients and healthy subjects. The DL and manual measurements outperformed the automated measurements of the built-in software.

scholarly journals Cortisol Levels and Autonomic Control of Heart Rate in Healthy Subjects

2017 ◽  
Vol 17 (2) ◽  
pp. 5-14 ◽  
Author(s):  
Milana Drumond Ramos Santana ◽  
Eli Carlos Martiniano ◽  
Larissa Raylane Lucas Monteiro ◽  
Maria Do Socorro Santos De Oliveira ◽  
Vitor E. Valenti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Salivary Cortisol ◽  
Healthy Subjects ◽  
Autonomic Control ◽  
Autonomic Modulation ◽  
Cardiac Autonomic Modulation ◽  
Cortisol Levels ◽  
Modulation Methods

AbstractIntroduction: There is an increase in level of stress in the general population because of the social, personal and professional demands. Currently, there are only simple tools that can safely measure this stress such as levels of cortisol and heart rate variability (HRV). Objective: To analyze the relationship between salivary cortisol and the cardiac autonomic modulation. Methods: A total of fifty-one male and female subjects between 18 and 40 years old were evaluated. Saliva collection was achieved for the salivary cortisol dosage. The collection was performed through the SalivetteR tube. After this collection, the median cortisol levels (0.24 ug/dl) were analyzed and the volunteers were divided into two groups: i) cortisol below the mediane ii) cortisol above the median. After this division, each group consisted of 25 volunteers and then was verified the following information: age, gender, weight, height, body mass index (BMI), blood pressure. Shortly thereafter was assessment of cardiac autonomic modulation por meio da HRV. The Polar RS800cx heart rate receiver was placed on the chest of the volunteers, in the vicinity of the distal third of the sternum. The volunteers were instructed to remain in rest with spontaneous breathing in dorsal position for 20 minutes. HRV analysis included geometric, time and frequency domain indices. Results: There were no statistical differences for the two groups regarding systolic and diastolic blood pressure, heart rate, RR intervals or linear and frequency indices for the volunteers. In addition, also there was no correlation the cortisol with the analyzed variables (SAP, p=0.460; DAP, p = 0.270; HR, p = 0.360; RR, p = 0.380; SDNN, p = 0.510; rMSSD, p = 0.660; pNN50, p = 0.820; RRtri, p = 0.170; TINN, p = 0.470; SD1, p = 0.650; SD2, p = 0.500; LF [ms2], p = 0.880; LF [nu], p = 0.970; HF [ms2], p = 0.870; HF [nu], p = 0.960; LF/HF, p = 0.380 Conclusion: Heart rate variability autonomic control was unchanged in healthy subjects with physiological distribution of salivary cortisol levels. There was no association between normal salivary cortisol and resting autonomic regulation of heart rate.

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