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Sacu S, Eibenberger K, Schmidl D, Rezar-Dreindl S, Garhöfer G, Brugger J, Buehl W, Schmetterer L, Schmidt-Erfurth U. Retinal oxygen saturation, vessel diameter and flicker response in eyes with specific subtypes of neovascular age-related macular degeneration during aflibercept treatment. PLoS One 2022; 17:e0271166. [PMID: 35819932 PMCID: PMC9275690 DOI: 10.1371/journal.pone.0271166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/22/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose To evaluate the effect of intravitreal aflibercept monotherapy on arterial and venous oxygen saturation, retinal vessel diameter and flicker response in patients with newly diagnosed specific subtypes of exudative maculopathy. Methods This prospective study included forty-four eyes of 44 patients with treatment-naïve polypoidal choroidal vasculopathy (PCV, n = 12), hemorrhagic choroidal neovascularization (hCNV, n = 12), pigment epithelium detachment (PED, n = 9) and type 3 MNV (RAP, n = 11). All patients received three initial aflibercept 2mg/0.05ml injections (Eylea®) in monthly intervals (loading phase) and were subsequently treated until month 12. Measurements of arterial and venous oxygen saturation, vessel diameters and flicker response were performed using the Dynamic Vessel Analyzer (DVA; IMEDOS, Jena, Germany). Statistical analysis was performed on the total population at baseline, after loading dose and at the last follow-up visit. Results The arterial oxygen saturation was 94.01±2.14% and showed no change after loading dose (93.94±2.88%, p = 0.4; estimated difference [confidence interval] -0.38 [-1.24; 0.48]) and at the last visit (95.48±1.90%; p = 0.1; -1.29 [-0.34; 2.91]). The venous oxygenation during treatment was 78.49±6.93% at baseline, 80.94±7.71% after 3-monthly injections (p = 0.7; -0.43 [-2.72; 1.86]) and 80.56±7.33% at month 12 (p = 0.5; 1.07 [-2.10; 4.24). The arterial and venous vessel diameters were 94±22μm and 131±19μm at baseline, and remained unchanged following aflibercept loading dose and at the last follow-up visit (p-value: p = 0.5; 2.30 [-5.00; 9.59] p = 0.8; 0.59 [-3.17; 4.34]). During stimulation with flicker light, arterial diameter changed by +1.24±4.93% at baseline and remained stable at month 3 (+2.70±5.95%; p = 0.5; 1.43 [-2.54; 5.41]) while the change in venous diameter during flicker stimulation was +4.52±4.45% at baseline and +4.13±3.65% after loading dose (p = 0.4, 5.18 [1.73; 8.63]). Conclusion During intravitreal aflibercept treatment oxygen saturation, vessel diameter and flicker response did not change in the total population of patients with specific subtypes of exudative maculopathy.
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Affiliation(s)
- Stefan Sacu
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | | | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Jonas Brugger
- Department of Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Wolf Buehl
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Singapore Eye Research Institute, Singapore, Singapore
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Sharifizad M, Schmidl D, Werkmeister RM, Zeisler H, Told R, Binder J, Küssel L, Garhöfer G, Schmetterer L. Retinal vessel diameters, flicker-induced retinal vasodilation and retinal oxygen saturation in high- and low-risk pregnancy. Acta Ophthalmol 2021; 99:628-636. [PMID: 33326186 PMCID: PMC8519143 DOI: 10.1111/aos.14696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/10/2020] [Indexed: 01/12/2023]
Abstract
Purpose To compare retinal vascular parameters between high‐risk and low‐risk pregnant women over time during pregnancy. Methods In a longitudinal study, we included pregnant women with normal blood pressure and normal body mass index (BMI, group 1), pregnant women with systemic hypertension and/or overweight (group 2) and age‐matched nonpregnant healthy women (group 3). Using the dynamic vessel analyser (DVA) we investigated flicker‐induced vasodilation in retinal arteries (FLA) and veins (FLV), central retinal arterial and vein equivalent (CRAE, CRVE), arterio‐venous ratio (AVR) and retinal arterial and venous oxygen saturation (SartO2, SveinO2). Study visits were scheduled 2nd trimester (TP 2), 3rd trimester (TP 3) and postpartum (PP). Results Data from 29 women in group 1, 25 women in group 2 and 33 women in group 3 were included for analysis. FLA, FLV, CRAE, CRVE, AVR and SveinO2 were altered in group 2 (p‐values between < 0.001 and 0.009). At TP 3 the differences between groups were most pronounced. In contrast, there were only minor differences between group 1 and 3. Changes in retinal parameters were independently associated with systemic blood pressure and BMI. Conclusions The present analysis indicates that flicker‐induced retinal vasodilation, retinal vessel diameters and retinal oxygen saturation are altered in high‐risk pregnant women. Hence, these parameters are candidate biomarkers for pregnancy complications, a hypothesis that deserves further study.
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Affiliation(s)
- Mozhgan Sharifizad
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - René M. Werkmeister
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
| | - Harald Zeisler
- Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
| | - Reinhard Told
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Department of Ophthalmology Medical University of Vienna Vienna Austria
| | - Julia Binder
- Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
| | - Lorenz Küssel
- Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Center for Medical Physics and Biomedical Engineering Medical University of Vienna Vienna Austria
- Singapore Eye Research Institute Singapore Singapore
- School of Chemical and Biomedical Engineering Nanyang Technological University Singapore Singapore
- SERI‐NTU Advanced Ocular Engineering (STANCE) Singapore Singapore
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Krytkowska E, Ulanczyk Z, Grabowicz A, Mozolewska-Piotrowska K, Safranow K, Palucha A, Krawczyk M, Sikora P, Matczynska E, Stahl A, Machalinski B, Machalinska A. Retinal Vessel Functionality Is Linked With ARMS2 A69S and CFH Y402H Polymorphisms and Choroidal Status in AMD Patients. Invest Ophthalmol Vis Sci 2021; 62:30. [PMID: 33900362 PMCID: PMC8088223 DOI: 10.1167/iovs.62.4.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We aimed to investigate the reactivity of retinal vessels to a flickering stimulus in patients with age-related macular degeneration (AMD) and healthy participants. We also assessed whether the parameters of retinal vessels are dependent on genetic predisposition. Methods A total of 354 patients with AMD and 121 controls were recruited for the study. All participants underwent thorough ophthalmologic examination and static and dynamic retinal vessel analysis. AMD risk polymorphisms were genotyped in the CFH and ARMS2 genes. Results We found no differences between the AMD group and controls in central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), arteriovenous ratio (AVR), dynamic analysis of arteries (DAAs), or dynamic analysis of veins (DAVs). Eyes with early AMD presented with significantly higher AVR values than eyes with late AMD. In the AMD group, DAA correlated positively with both choroidal thickness (Rs = 0.14, P = 0.00096) and choroidal volume (Rs = 0.23, P < 0.0001), and no such associations were observed in the controls. We found significantly lower DAA (1.47 ± 1.50) in TT homozygotes for the ARMS2 A69S polymorphism in comparison with GG homozygotes (2.38 ± 1.79) and patients with GG + GT genotypes (2.28 ± 1.84). We also observed less prominent DAV (3.24 ± 1.71) in patients with TC + CC genotypes in the CFH Y402H polymorphism compared with TT homozygotes (3.83 ± 1.68). Conclusions Our findings suggest that retinal microcirculation appears to be associated with the genetic background, choroidal parameters, and clinical features of the patients with AMD.
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Affiliation(s)
- Elzbieta Krytkowska
- First Department of Ophthalmology, Pomeranian Medical University, Szczecin, Poland
| | - Zofia Ulanczyk
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Aleksandra Grabowicz
- First Department of Ophthalmology, Pomeranian Medical University, Szczecin, Poland
| | | | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | | | | | | | | | - Andreas Stahl
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Boguslaw Machalinski
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Anna Machalinska
- First Department of Ophthalmology, Pomeranian Medical University, Szczecin, Poland
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Su X, Zheng H, Li Q, Sun P, Zhou M, Li H, Guo J, Chai X, Zhou C. Retinal neurovascular responses to transcorneal electrical stimulation measured with optical coherence tomography. Exp Biol Med (Maywood) 2020; 245:289-300. [PMID: 31958987 DOI: 10.1177/1535370219900495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Noninvasive transcorneal electrical stimulation (TES) has emerged as a potential strategy to facilitate visual restoration and promote retinal cell survival for certain retinal and optic nerve diseases owing to its neuroprotective effects. However, the neurovascular responses of retinal neurons evoked by TES have not been completely determined. To investigate this issue, we utilized a custom-designed spectral-domain optical coherence tomography (SD-OCT) to record the retinal neural and vascular responses under TES in vivo simultaneously. Significant increases of both positive and negative intrinsic optical signal (IOS) changes were recorded in all three segmented retinal layers, which mainly related to neural activities. However, the changes of TES-induced retinal vascular responses, including blood velocity, cross-sectional area of vessel, and blood flow, were not significant. It suggests that TES mainly elicited neural responses in retina, while no significant vascular responses were evoked. Our results provide experimental evidence to the mechanism of retinal neurovascular coupling under TES. Additionally, the present study also suggests that SD-OCT could be utilized as a promoting method to explore neurovascular responses under retinal stimulation in clinical treatment and technology. Impact statement Noninvasive transcorneal electrical stimulation (TES) has emerged as an effective treatment for certain retinal and optic nerve diseases owing to its neuroprotective effects. However, the retinal neurovascular responses evoked by TES have not been completely determined. To investigate this issue, we utilized a custom-designed spectral-domain optical coherence tomography (SD-OCT) to record the retinal neural and vascular responses evoked by TES in vivo simultaneously. The present study suggested that TES mainly elicited neural responses in retina, while no significant vascular responses were evoked. Our results provide experimental evidence to the mechanism of retinal neurovascular coupling evoked by TES. Additionally, the present study also suggests that SD-OCT could be utilized as a promoting method to explore neurovascular responses under retinal electrical stimulation.
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Affiliation(s)
- Xiaofan Su
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hao Zheng
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qian Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna 1090, Austria
| | - Pengcheng Sun
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Meixuan Zhou
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Heng Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jiahui Guo
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xinyu Chai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Chuanqing Zhou
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.,Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen 518055, China
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Son T, Wang B, Lu Y, Chen Y, Cao D, Yao X. Concurrent OCT imaging of stimulus evoked retinal neural activation and hemodynamic responses. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2017; 10045. [PMID: 29225397 DOI: 10.1117/12.2252480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
It is well established that major retinal diseases involve distortions of the retinal neural physiology and blood vascular structures. However, the details of distortions in retinal neurovascular coupling associated with major eye diseases are not well understood. In this study, a multi-modal optical coherence tomography (OCT) imaging system was developed to enable concurrent imaging of retinal neural activity and vascular hemodynamics. Flicker light stimulation was applied to mouse retinas to evoke retinal neural responses and hemodynamic changes. The OCT images were acquired continuously during the pre-stimulation, light-stimulation, and post-stimulation phases. Stimulus-evoked intrinsic optical signals (IOSs) and hemodynamic changes were observed over time in blood-free and blood regions, respectively. Rapid IOSs change occurred almost immediately after stimulation. Both positive and negative signals were observed in adjacent retinal areas. The hemodynamic changes showed time delays after stimulation. The signal magnitudes induced by light stimulation were observed in blood regions and did not show significant changes in blood-free regions. These differences may arise from different mechanisms in blood vessels and neural tissues in response to light stimulation. These characteristics agreed well with our previous observations in mouse retinas. Further development of the multi-modal OCT may provide a new imaging method for studying how retinal structures and metabolic and neural functions are affected by age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), and other diseases, which promises novel noninvasive biomarkers for early disease detection and reliable treatment evaluations of eye diseases.
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Affiliation(s)
- Taeyoon Son
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Benquan Wang
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Yiming Lu
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Yanjun Chen
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Xincheng Yao
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA.,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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Son T, Wang B, Thapa D, Lu Y, Chen Y, Cao D, Yao X. Optical coherence tomography angiography of stimulus evoked hemodynamic responses in individual retinal layers. BIOMEDICAL OPTICS EXPRESS 2016; 7:3151-62. [PMID: 27570706 PMCID: PMC4986822 DOI: 10.1364/boe.7.003151] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/08/2016] [Accepted: 06/10/2016] [Indexed: 05/05/2023]
Abstract
Blood flow changes are highly related to neural activities in the retina. It has been reported that neural activity increases when flickering light stimulation of the retina is used. It is known that blood flow changes with flickering light stimulation can be altered in patients with vascular disease and that measurement of flicker-induced vasodilatation is an easily applied tool for monitoring functional microvascular alterations. However, details of distortions in retinal neurovascular coupling associated with major eye diseases are not well understood due to the limitation of existing techniques. In this study, flickering light stimulation was applied to mouse retinas to investigate stimulus evoked hemodynamic responses in individual retinal layers. A spectral domain optical coherence tomography (OCT) angiography imaging system was developed to provide dynamic mapping of hemodynamic responses in the ganglion cell layer, inner plexiform layer, outer plexiform layer and choroid layer before, during and after flickering light stimulation. Experimental results showed hemodynamic responses with different magnitudes and time courses in individual retinal layers. We anticipate that the dynamic OCT angiography of stimulus evoked hemodynamic responses can greatly foster the study of neurovascular coupling mechanisms in the retina, promising new biomarkers for retinal disease detection and diagnosis.
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Affiliation(s)
- Taeyoon Son
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Benquan Wang
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Damber Thapa
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Yiming Lu
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Yanjun Chen
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Xincheng Yao
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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