1
|
Shats D, Balasubramanian T, Sidelnikov D, Das U, Onyekaba NA, Forbes HE, Lu N, Williams K, Levin MR, Sundararajan S, Vij S, Gadagkar H, Rege A, Saeedi O, Chen V, Alexander JL. Association of Speckle-Based Blood Flow Measurements and Fluorescein Angiography in Infants with Retinopathy of Prematurity. OPHTHALMOLOGY SCIENCE 2024; 4:100463. [PMID: 38591050 PMCID: PMC11000102 DOI: 10.1016/j.xops.2023.100463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/01/2023] [Accepted: 12/26/2023] [Indexed: 04/10/2024]
Abstract
Purpose To determine the correlation between blood flow metrics measured by intravenous fluorescein angiography (IVFA) and the blood flow velocity index (BFVi) obtained by laser speckle contrast imaging (LSCI) in infants with retinopathy of prematurity (ROP). Design Prospective comparative pilot study. Subjects Seven eyes from 7 subjects with ROP. Methods Unilateral LSCI and IVFA data were obtained from each subject in the neonatal intensive care unit. Five LSCI-based metrics and 5 IVFA-based metrics were extracted from images to quantify blood flow patterns in the same region of interest. Correlation between LSCI-based and IVFA-based blood flow metrics was compared between 2 subgroups of ROP severity: moderate ROP (defined as stage ≤ 2 without Plus disease) and severe ROP (defined as stage ≥3 or Plus disease). Main Outcome Measures Pearson and Kendall rank correlation coefficients between IVFA and LSCI metrics; Student t test P values comparing LSCI metrics between "severe" and "moderate" ROP groups. Results Pearson correlations between IVFA and LSCI included arterial-venous transit time (AVTT) and peak BFVi (pBFVi; r = -0.917; P = 0.004), AVTT and dip BFVi (dBFVi; r = -0.920; P = 0.003), AVTT and mean BFVi (r = -0.927- P = 0.003), and AVTT and volumetric rise index (r = -0.779; P = 0.039). Kendall rank correlation between AVTT and dBFVi was r = -0.619 (P = 0.051). pBFVi was higher in severe ROP than in moderate ROP (8.4 ± 0.6 and 4.4 ± 1.8, respectively; P = 0.0045 using the 2-sample t test with pooled variance and P = 0.0952 using the Wilcoxon rank-sum test). Conclusions Correlation was found between blood flow metrics obtained by IVFA and noninvasive LSCI techniques. We demonstrate the feasibility of obtaining quantitative metrics using LSCI in infants with ROP in this pilot study; however, further investigation is needed to evaluate its potential use in clinical assessment of ROP severity. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Daniel Shats
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Tara Balasubramanian
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Danielle Sidelnikov
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Urjita Das
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Ndidi-Amaka Onyekaba
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - He E. Forbes
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Noela Lu
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kristin Williams
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Moran R. Levin
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sripriya Sundararajan
- Department of Neonatology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Shitiz Vij
- Vasoptic Medical, Inc., Columbia, Maryland
| | | | | | - Osamah Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Victoria Chen
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Janet L. Alexander
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| |
Collapse
|
2
|
Adejumo T, Ma G, Son T, Kim TH, Le D, Dadzie AK, Ahmed S, Yao X. Adaptive vessel tracing and segmentation in OCT enables the robust detection of wall-to-lumen ratio abnormalities in 5xFAD mice. BIOMEDICAL OPTICS EXPRESS 2023; 14:6350-6360. [PMID: 38420326 PMCID: PMC10898580 DOI: 10.1364/boe.504317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/25/2023] [Accepted: 11/12/2023] [Indexed: 03/02/2024]
Abstract
The wall-to-lumen ratio (WLR) of retinal blood vessels promises a sensitive marker for the physiological assessment of eye conditions. However, in vivo measurement of vessel wall thickness and lumen diameter is still technically challenging, hindering the wide application of WLR in research and clinical settings. In this study, we demonstrate the feasibility of using optical coherence tomography (OCT) as one practical method for in vivo quantification of WLR in the retina. Based on three-dimensional vessel tracing, lateral en face and axial B-scan profiles of individual vessels were constructed. By employing adaptive depth segmentation that adjusts to the individual positions of each blood vessel for en face OCT projection, the vessel wall thickness and lumen diameter could be reliably quantified. A comparative study of control and 5xFAD mice confirmed WLR as a sensitive marker of the eye condition.
Collapse
Affiliation(s)
- Tobiloba Adejumo
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Guangying Ma
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Taeyoon Son
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Tae-Hoon Kim
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - David Le
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Albert K Dadzie
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Shaiban Ahmed
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Xincheng Yao
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
| |
Collapse
|
3
|
Wang X, Wang M, Liu H, Mercieca K, Prinz J, Feng Y, Prokosch V. The Association between Vascular Abnormalities and Glaucoma-What Comes First? Int J Mol Sci 2023; 24:13211. [PMID: 37686017 PMCID: PMC10487550 DOI: 10.3390/ijms241713211] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide. While intraocular pressure (IOP) presents a major risk factor, the underlying pathophysiology still remains largely unclear. The correlation between vascular abnormalities and glaucoma has been deliberated for decades. Evidence for a role played by vascular factors in the pathogenesis of glaucomatous neurodegeneration has already been postulated. In addition, the fact that glaucoma causes both structural and functional changes to retinal blood vessels has been described. This review aims to investigate the published evidence concerning the relationship between vascular abnormalities and glaucoma, and to provide an overview of the "chicken or egg" dilemma in glaucoma. In this study, several biomarkers of glaucoma progression from a vascular perspective, including endothelin-1 (ET-1), nitric oxide, vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs), were identified and subsequently assessed for their potential as pharmacological intervention targets.
Collapse
Affiliation(s)
- Xiaosha Wang
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Maoren Wang
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hanhan Liu
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Karl Mercieca
- Glaucoma Section, University Hospital Eye Clinic, 53127 Bonn, Germany;
- Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester M13 9WH, UK
| | - Julia Prinz
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, RWTH Aachen University, 52074 Aachen, Germany
| | - Yuan Feng
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Verena Prokosch
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| |
Collapse
|
4
|
Leveque AS, Bouisse M, Labarere J, Trucco E, Hogg S, MacGillivray T, Aptel F, Chiquet C. Retinal vessel architecture and geometry are not impaired in normal-tension glaucoma. Sci Rep 2023; 13:6713. [PMID: 37185916 PMCID: PMC10130140 DOI: 10.1038/s41598-023-33361-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
To investigate the associations between retinal vessel parameters and normal-tension glaucoma (NTG). We conducted a case-control study with a prospective cohort, allowing to record 23 cases of NTG. We matched NTG patient with one primary open-angle glaucoma (POAG) and one control per case by age, systemic hypertension, diabetes, and refraction. Central retinal artery equivalent (CRAE), central retinal venule equivalent (CRVE), Arteriole-To-Venule ratio (AVR), Fractal Dimension and tortuosity of the vascular network were measured using VAMPIRE software. Our sample consisted of 23 NTG, 23 POAG, and 23 control individuals, with a median age of 65 years (25-75th percentile, 56-74). No significant differences were observed in median values for CRAE (130.6 µm (25-75th percentile, 122.8; 137.0) for NTG, 128.4 µm (124.0; 132.9) for POAG, and 135.3 µm (123.3; 144.8) for controls, P = .23), CRVE (172.1 µm (160.0; 188.3), 172.8 µm (163.3; 181.6), and 175.9 µm (167.6; 188.4), P = .43), AVR (0.76, 0.75, 0.74, P = .71), tortuosity and fractal parameters across study groups. Vascular morphological parameters were not significantly associated with retinal nerve fiber layer thickness or mean deviation for the NTG and POAG groups. Our results suggest that vascular dysregulation in NTG does not modify the architecture and geometry of the retinal vessel network.
Collapse
Affiliation(s)
- Anne-Sophie Leveque
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 09, France
| | - Magali Bouisse
- Clinical Epidemiology Unit, Grenoble Alpes University Hospital, Grenoble, France
- Univ. Grenoble Alpes, CNRS, UMR 5525, TIMC, Grenoble, France
| | - José Labarere
- Clinical Epidemiology Unit, Grenoble Alpes University Hospital, Grenoble, France
- Univ. Grenoble Alpes, CNRS, UMR 5525, TIMC, Grenoble, France
| | - Emanuele Trucco
- VAMPIRE Project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Stephen Hogg
- VAMPIRE Project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Tom MacGillivray
- VAMPIRE Project, Centre for Clinical Brain Science, University of Edinburgh, Edinburgh, UK
| | - Florent Aptel
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 09, France
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, Grenoble, France
| | - Christophe Chiquet
- Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 09, France.
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, Grenoble, France.
| |
Collapse
|
5
|
Yousef EN, Dasgupta PK, Horn SA, Shelor CP, Roy S. Geometric characterization of polymeric capillaries. Anal Chim Acta 2022; 1229:340345. [PMID: 36156221 DOI: 10.1016/j.aca.2022.340345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/01/2022]
Abstract
There are few methods in the literature to measure the inner diameter of very small capillaries. Although silica capillaries are more commonly used, synthetic polymer capillaries are preferred in some applications. The technology for producing them is not as mature. Aside from the absolute value of the inner diameter, the circularity, concentricity (a quantitative index is defined here for the first time) and the bore uniformity of such capillaries are of interest. Beyond microscopy, we describe multiple methods that determine the capillary inner diameter, averaged over a given length. The measurements variously depended on the capillary internal volume, length and cross section, and the resistance to fluid flow. The different approaches produced mutually consistent results. We show that when the internal diameter is not uniform, the different dependence on diameter that two such methods may exhibit, can be exploited to determine the true mean diameter as well as its variance. Finally, for open tubular liquid chromatography, where performance acutely depends on the inner diameter, we surprisingly find that while the mean i.d. may be the dominant determinant of efficiency, bore variance has little to no effect on the performance.
Collapse
Affiliation(s)
- Enas N Yousef
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, TX, 76019-0065, United States
| | - Purnendu K Dasgupta
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, TX, 76019-0065, United States.
| | - Seth A Horn
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, TX, 76019-0065, United States
| | - C Phillip Shelor
- Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, TX, 76019-0065, United States
| | - Souvik Roy
- Department of Mathematics, University of Texas at Arlington, Arlington, TX, 76019-0408, United States
| |
Collapse
|
6
|
Intraocular Pressure-Induced Endothelial Dysfunction of Retinal Blood Vessels Is Persistent, but Does Not Trigger Retinal Ganglion Cell Loss. Antioxidants (Basel) 2022; 11:antiox11101864. [PMID: 36290587 PMCID: PMC9598728 DOI: 10.3390/antiox11101864] [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] [Received: 08/30/2022] [Revised: 09/11/2022] [Accepted: 09/15/2022] [Indexed: 12/02/2022] Open
Abstract
Research has been conducted into vascular abnormalities in the pathogenesis of glaucoma, but conclusions remain controversial. Our aim was to test the hypothesis that retinal endothelial dysfunction induced by elevated intraocular pressure (IOP) persists after IOP normalization, further triggering retinal ganglion cell (RGC) loss. High intraocular pressure (HP) was induced in mice by episcleral vein occlusion (EVO). Retinal vascular function was measured via video microscopy in vitro. The IOP, RGC and their axons survival, levels of oxidative stress and inflammation as well as vascular pericytes coverage, were determined. EVO caused HP for two weeks, which returned to baseline afterwards. Mice with HP exhibited endothelial dysfunction in retinal arterioles, reduced density of RGC and their axons, and loss of pericytes in retinal arterioles. Notably, these values were similar to those of mice with recovered IOP (RP). Levels of oxidative stress and inflammation were increased in HP mice but went back to normal in the RP mice. Our data demonstrate that HP induces persistent endothelial dysfunction in retinal arterioles, which persists one month after RP. Oxidative stress, inflammation, and loss of pericytes appear to be involved in triggering vascular functional deficits. Our data also suggest that retinal endothelial dysfunction does not affect RGC and their axon survival.
Collapse
|
7
|
Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography. Sci Rep 2020; 10:18717. [PMID: 33127916 PMCID: PMC7603312 DOI: 10.1038/s41598-020-73223-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022] Open
Abstract
This study analyzed the optical coherence tomography angiography (OCTA) macular parameters in primary angle-closure glaucoma (PACG) patients after acute primary angle closure (APAC) episodes. Thirty-three patients with 33 APAC eyes and 33 primary angle closure suspect (PACS) eyes and 33 age-matched normal subjects (controls) were enrolled. Macular vessel density (VD) in central, inner, outer and full regions and foveal avascular zone (FAZ) parameters (area, perimeter and circularity index) were compared between APAC, PACS, and control eyes. For resolved APAC eyes, the VD in each macular region was significantly lower than that in control eyes, with less central and inner macular VD than PACS eyes. The central macular VD was significantly lower in PACS eyes than in controls. There was no difference in FAZ area and perimeter between APAC, PACS, and control eyes. FAZ circularity was highest in control eyes, followed by PACS eyes, and lowest in APAC eyes. The AUC, sensitivity and specificity of FAZ circularity were 0.944, 93.9% and 84.8%, respectively, in APAC eyes and 0.881, 84.8% and 81.8%, respectively, in PACS eyes. Therefore, FAZ circularity had the best discrimination capability for detecting both APAC and PACS eyes. Macular assessment with OCTA could provide an accurate early-stage diagnostic tool for PACG.
Collapse
|
8
|
Mastropasqua R, D’Aloisio R, Agnifili L, Zuppardi E, Di Marzio G, Di Nicola M, Porreca A, Guarini D, Totta M, Brescia L, Di Antonio L. Functional and Structural Reliability of Optic Nerve Head Measurements in Healthy Eyes by Means of Optical Coherence Tomography Angiography. ACTA ACUST UNITED AC 2020; 56:medicina56010044. [PMID: 31968630 PMCID: PMC7023288 DOI: 10.3390/medicina56010044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 12/03/2022]
Abstract
Background and Objectives: the aim of the study was to evaluate the repeatability and reproducibility of optical microangiography (OMAG)-based optical coherence tomography angiography (OCTA) in the optic nerve head (ONH) and radial peripapillary capillary (RPC) perfusion assessment of healthy eyes. Materials and Methods: in this observational study, a total of 40 healthy subjects underwent ONH evaluation, using an OMAG-based OCTA system at baseline (T0), after 30 min (T1), and after 7 days (T2). The main outcome measures were the vessel density (VD) and flux index (FI) of the RPCs, as well as peri-papillary retinal nerve fibre layer (pRNFL) thickness. The analysis was performed by two observers independently. The coefficient of repeatability (CR), within the subject coefficient of variation (CVw) and intrasession correlation coefficient (ICC), to evaluate intrasession repeatability of measurements was calculated for each observer. Results: the high intrasession and intersession repeatability and reproducibility were assessed in the two observers for all three outcome measures. Of note, the CRs for the first and the second observer were 0.011 (95% confidence interval (CI) 0.009–0.014) and 0.016 (95% CI 0.013–0.020) for FI, 0.016 (95% CI 0.013–0.021) and 0.017 (95% CI 0.014–0.021) for VD, and 2.400 (95% CI 1.948–3.092) and 3.732 (95% CI 3.064–4.775) for pRNFL thickness, respectively. The agreement between them was excellent for pRNFL assessment and very good for FI and VD. Conclusion: OCTA has a great potential in the accurate assessment of ONH and peri-papillary microcirculation. It allows for repeated and reproducible measurements without multiple scans-related bias, thus guaranteeing an independent operator analysis with good reproducibility and repeatability.
Collapse
Affiliation(s)
- Rodolfo Mastropasqua
- Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol BS8 1TH, UK;
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
- Correspondence: ; Tel.: +39-087-135-8410; Fax: +39-087-135-7294
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| | - Eduardo Zuppardi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| | - Guido Di Marzio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy;
| | - Annamaria Porreca
- Department of Economic Studies, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy;
| | - Daniele Guarini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| | - Michele Totta
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.A.); (E.Z.); (G.D.M.); (D.G.); (M.T.); (L.B.); (L.D.A.)
| |
Collapse
|
9
|
Kromer R, Glusa P, Framme C, Pielen A, Junker B. Optical coherence tomography angiography analysis of macular flow density in glaucoma. Acta Ophthalmol 2019; 97:e199-e206. [PMID: 30178601 DOI: 10.1111/aos.13914] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 08/09/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Modifications in ocular blood flow may play a significant role in glaucoma development. Optical coherence tomography angiography (OCT-A) is based on the detection and analysis of the reflection behaviour of motion in a static environment and therefore is able to quantify the retinal flow density. We used this new technology to examine the density of the active flow vasculature in the macular area in glaucoma patients compared to healthy patients. METHODS Thirty patients with primary open-angle glaucoma (mean age: 72.6 ± 7.1 years) and 21 healthy patients (mean age: 70.3 ± 8.6 years) were recruited. Patients received perimetry and OCT measurements of the peripapillary retinal nerve fibre layer thickness (RNFLT) and macular retinal thickness and OCT-A of the macular area in the superficial and deep retinal (DR) plexus. Flow density of the OCT-A scan was calculated by binarisation and quantification of the pixel density. RESULTS Macular flow density was globally and nasally reduced in glaucoma patients in the superficial (globally: p = 0.0203; nasally: p = 0.0003) and DR plexus (globally: p = 0.0113, nasally: p < 0.0001). There was no significant difference between the superficial retina and the DR concerning the flow density. Flow density showed no significant correlation with perimetry results, RNFLT or retinal segment thickness. CONCLUSION Patients with glaucoma exhibit a reduced macular flow density measured by OCT-A compared to controls. The independence of the macular flow density of the retinal segment thickness changes could indicate an altered vascular element in patients with glaucoma.
Collapse
Affiliation(s)
- Robert Kromer
- Hannover Medical School University Eye Hospital Hannover Germany
- Department of Ophthalmology University Hospital Hamburg‐Eppendorf Hamburg Germany
| | - Philipp Glusa
- Hannover Medical School University Eye Hospital Hannover Germany
| | - Carsten Framme
- Hannover Medical School University Eye Hospital Hannover Germany
| | - Amelie Pielen
- Hannover Medical School University Eye Hospital Hannover Germany
| | - Bernd Junker
- Hannover Medical School University Eye Hospital Hannover Germany
| |
Collapse
|
10
|
Wei X, Balne PK, Meissner KE, Barathi VA, Schmetterer L, Agrawal R. Assessment of flow dynamics in retinal and choroidal microcirculation. Surv Ophthalmol 2018; 63:646-664. [DOI: 10.1016/j.survophthal.2018.03.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 01/08/2023]
|
11
|
Newman A, Andrew N, Casson R. Review of the association between retinal microvascular characteristics and eye disease. Clin Exp Ophthalmol 2017; 46:531-552. [PMID: 29193621 DOI: 10.1111/ceo.13119] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 10/29/2017] [Accepted: 11/22/2017] [Indexed: 12/20/2022]
Abstract
Computerized retinal imaging technologies enable the static and dynamic measurement of a range of retinal microvascular parameters. Large population-based studies have reported associations between these microvascular indices and various ophthalmic diseases including diabetes, age-related macular degeneration, retinal artery embolism, retinal vein occlusion, glaucoma and non-glaucomatous optic neuropathies. Increasingly, sophisticated imaging and analysis techniques have the potential to provide relevant clinical information regarding disease risk and progression; however, further studies are required to verify associations and strengthen the predictive power of these techniques. We summarize the current state of knowledge regarding retinal microvascular characteristics and eye disease.
Collapse
Affiliation(s)
- Alexander Newman
- Department of Ophthalmology, Gold Coast University Hospital, Queensland, Australia.,Griffith University School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Nicholas Andrew
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert Casson
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
12
|
Foveal Avascular Zone in Normal Tension Glaucoma Measured by Optical Coherence Tomography Angiography. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3079141. [PMID: 29392131 PMCID: PMC5748133 DOI: 10.1155/2017/3079141] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/22/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022]
Abstract
Aim To measure diameter of foveal avascular zone (FAZ), FAZ area, and vessel density using Optical Coherence Tomography Angiography (OCT-A) in patients with normal tension glaucoma (NTG) and to establish the possible role of OCT-A in diagnosis and follow-up of patients with NTG. Methods Twenty-one eyes of 21 patients with NTG and 30 eyes of 30 healthy subjects underwent complete ophthalmic examination as well as OCT-A on ZEISS AngioPlex. 3 × 3 macula scans were used to measure vertical, horizontal, and maximum diameter of FAZ by two graders. Mean values and interobserver variability were analyzed. Image J was used for analysis of FAZ area and vessel density. Results Mean vertical diameter (t = 5.58, p < 0.001), horizontal diameter (t = 3.59, p < 0.001), maximum diameter (t = 5.94, p < 0.001), and FAZ area (t = 5.76, p < 0.001) were statistically significantly enlarged in the NTG group compared to those in the control group. Vessel density (t = -5.80, p < 0.001) was statistically significantly decreased in the NTG group compared to that in the control group. Conclusion OCT-A could have an important role in the future in diagnosis of patients with NTG. In patients with NTG, there is larger FAZ area, while the vessel density is reduced in comparison to the control group.
Collapse
|
13
|
Hui F, Nguyen CTO, He Z, Vingrys AJ, Gurrell R, Fish RL, Bui BV. Retinal and Cortical Blood Flow Dynamics Following Systemic Blood-Neural Barrier Disruption. Front Neurosci 2017; 11:568. [PMID: 29075176 PMCID: PMC5643486 DOI: 10.3389/fnins.2017.00568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/28/2017] [Indexed: 12/11/2022] Open
Abstract
To consider whether imaging retinal vasculature may be used as a marker for cortical vessels, we compared fluorescein angiography flow dynamics before and after pharmacological disruption of blood-neural barriers. Sodium fluorescein (1%, 200 μl/kg) was intravenously delivered in anesthetized adult Long Evans rats (n = 44, brain = 18, retina = 26). In the brain cohort, a cranial window was created to allow direct visualization of surface cortical vessels. Video fluorescein angiography was captured using a rodent retinal camera at 30 frames/second and fluorescence intensity profiles were evaluated for the time to reach 50% brightness (half-rise), 50% decay (half-fall), and the plateau level of remnant fluorescence (offset, %). Cortical vessels fluoresced earlier (artery half-rise: 5.6 ± 0.2 s) and decayed faster (half-fall: 10.3 ± 0.2 s) compared to retinal vasculature. Cortical vessels also had a considerably higher offset, particularly in the capillaries/extravascular space (41.4 ± 2.7%) whereas pigment in the retina reduces such residual fluorescence. In a sub-cohort of animals, sodium deoxycholate (DOC, 0.06 M dissolved in sterile saline, 1 mL) was delivered intravenously to cause simultaneous disruption of the blood-brain and blood-retinal barriers. A separate group received saline as vehicle control. Fluorescein angiography was re-measured at 6 and 24 h after drug infusion and evaluated by comparing flow dynamics to the upper quartile (75%) of the control group. Retinal vasculature was more sensitive to DOC-induced disruption with a higher fluorescence offset at 6 h (47.3 ± 10.6%). A delayed effect was seen in cortical vessels with a higher offset evident only at 24 h (65.6 ± 10.1%). Here we have developed a method to quantitatively compare fluorescein angiography dynamics in the retina and superficial cortical vessels. Our results show that systemic disruption of blood-neural barriers causes vascular leakage in both tissues but earlier in the retina suggesting that pharmacological blood-neural barrier disruption may be detected earlier in the eye than in cortical vasculature.
Collapse
Affiliation(s)
- Flora Hui
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Christine T. O. Nguyen
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Algis J. Vingrys
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Rachel Gurrell
- Neuroscience and Pain Research Unit, Pfizer, Cambridge, United Kingdom
| | - Rebecca L. Fish
- Neuroscience and Pain Research Unit, Pfizer, Cambridge, United Kingdom
| | - Bang V. Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
14
|
Abstract
PURPOSE OF THE STUDY The purpose of the study was to evaluate retinal vessel diameter in age-matched normal tension glaucoma (NTG) and primary open angle glaucoma (POAG) eyes with hemifield involvement. METHODS Fundus photographs of patients with hemifield defect, good visibility of retinal nerve fiber layer defect, and vessels were compared with 30 controls. One eye of each patient (28 NTG and 30 POAG) was randomly chosen for analysis using Image J software by different clinicians at 2 levels. The structural parameters analyzed included retinal nerve fiber layer defect width, diameter of vessels (superotemporal or inferotemporal artery and superotemporal or inferotemporal vein). RESULTS The average superotemporal artery diameter was similar in NTG (71±16.8 µm), POAG (79±26.6 µm), and controls (82±14.1 µm), P=0.2 with similar pattern seen for other vessels. The affected quadrant in all eyes and those with disc hemorrhage (n=8) did not have significantly different arteries and veins diameter as compared with the unaffected quadrant in that eye. No relation of artery or vein diameter with retinal nerve fiber layer defect width or clinical variables in NTG or POAG eyes was seen on multivariate regression analysis. CONCLUSIONS The vessel diameter was not significantly different in the affected and unaffected quadrants of age and severity-matched NTG and POAG eyes with hemifield structural and functional defect as reported in earlier studies. These results point toward the possibility that vascular diameter changes may not be the cause for glaucomatous changes.
Collapse
|
15
|
Chan KKW, Tang F, Tham CCY, Young AL, Cheung CY. Retinal vasculature in glaucoma: a review. BMJ Open Ophthalmol 2017; 1:e000032. [PMID: 29354699 PMCID: PMC5721639 DOI: 10.1136/bmjophth-2016-000032] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/13/2017] [Accepted: 03/20/2017] [Indexed: 01/03/2023] Open
Abstract
Despite the critical impact of glaucoma on global blindness, its aetiology is not fully characterised. Elevated intraocular pressure is highly associated with glaucomatous optic neuropathy. However, visual field loss still progresses in some patients with normal or even low intraocular pressure. Vascular factors have been suggested to play a role in glaucoma development, based on numerous studies showing associations of glaucoma with blood pressure, ocular perfusion pressure, vasospasm, cardiovascular disease and ocular blood flow. As the retinal vasculature is the only part of the human circulation that readily allows non-invasive visualisation of the microcirculation, a number of quantitative retinal vascular parameters measured from retinal photographs using computer software (eg, calibre, fractal dimension, tortuosity and branching angle) are currently being explored for any association with glaucoma and its progression. Several population-based and clinical studies have reported that changes in retinal vasculature (eg, retinal arteriolar narrowing and decreased fractal dimension) are associated with optic nerve damage and glaucoma, supporting the vascular theory of glaucoma pathogenesis. This review summarises recent findings on the relationships between quantitatively measured structural retinal vascular changes with glaucoma and other markers of optic nerve head damage, including retinal nerve fibre layer thickness. Clinical implications, recent new advances in retinal vascular imaging (eg, optical coherence tomography angiography) and future research directions are also discussed.
Collapse
Affiliation(s)
- Karen K W Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Fangyao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Clement C Y Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
16
|
Chen CL, Zhang A, Bojikian KD, Wen JC, Zhang Q, Xin C, Mudumbai RC, Johnstone MA, Chen PP, Wang RK. Peripapillary Retinal Nerve Fiber Layer Vascular Microcirculation in Glaucoma Using Optical Coherence Tomography-Based Microangiography. Invest Ophthalmol Vis Sci 2017; 57:OCT475-85. [PMID: 27442341 PMCID: PMC4968914 DOI: 10.1167/iovs.15-18909] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Purpose To investigate the vascular microcirculation changes in the retinal nerve fiber layer (RNFL) in normal, glaucoma suspect, and open-angle glaucoma (OAG) groups using optical coherence tomography–based microangiography (OMAG). Methods One eye from each subject was scanned with a Cirrus HD-OCT 5000–based OMAG prototype system montage scanning protocol centered at the optic nerve head (ONH). Blood flow signals were extracted using OMAG algorithm. Retinal nerve fiber layer vascular microcirculation was measured by calculating the blood flux index and vessel area density within a 1.2-mm width annulus centered at the ONH with exclusion of big retinal vessels. One-way ANOVA were performed to analyze the RNFL microcirculation among groups. Linear-regression models were constructed to analyze the correlation between RNFL microcirculation and clinical parameters. Discrimination capabilities of the flow metrics were assessed with the area under the receiver operating characteristic curve (AROC). Results Twenty normal, 26 glaucoma suspect, and 42 OAG subjects were enrolled. Eyes from OAG subjects and glaucoma suspects showed significantly lower blood flux index compared with normal eyes (P ≤ 0.0015). Retinal nerve fiber layer blood flow metrics showed significant correlations with visual field indices and structural changes in glaucomatous eyes (P ≤ 0.0123). Similar discrimination capability of blood flux index compared with RNFL thickness was found in both disease groups. Conclusions Peripapillary RNFL vascular microcirculation measured as blood flux index by OMAG showed significant differences among OAG, glaucoma suspect, and normal controls and was significantly correlated with functional and structural defects. Retinal nerve fiber layer microcirculation measurement using OMAG may help physicians monitor glaucoma.
Collapse
Affiliation(s)
- Chieh-Li Chen
- Department of Bioengineering, University of Washington, Seattle, Washington, United States 2Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Anqi Zhang
- Department of Bioengineering, University of Washington, Seattle, Washington, United States
| | - Karine D Bojikian
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Joanne C Wen
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Qinqin Zhang
- Department of Bioengineering, University of Washington, Seattle, Washington, United States
| | - Chen Xin
- Department of Bioengineering, University of Washington, Seattle, Washington, United States 3Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Raghu C Mudumbai
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Murray A Johnstone
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Philip P Chen
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, United States 2Department of Ophthalmology, University of Washington, Seattle, Washington, United States
| |
Collapse
|
17
|
Esteves R, Freitas T, Teixeira P, Napoleão P, Neves C, Saldanha C. Erythrocyte nitric oxide in glaucoma patients - ex vivo study. Clin Hemorheol Microcirc 2017; 64:989-994. [PMID: 27814293 DOI: 10.3233/ch-168049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Glaucoma is an optic neuropathy associated with vascular dysregulation and increased intra-ocular pressure (IOP). Timolol is used as treatment for reducing IOP, by limiting aqueous humour production. Increased NOS expression as well as decreased levels of nitric oxide (NO) metabolites, and high activity of erythrocyte acetylcholinesterase (AChE) were observed in primary open angle glaucoma patients. OBJECTIVE This ex vivo study aims to evaluate timolol effect in NO efflux and its derivatives in glaucoma patient's erythrocytes. METHODS Venous blood from 15 glaucoma patients was collected. Erythrocyte suspensions were incubated with the AChE modulators acetylcholine (ACh) and timolol at 10 μM. Erythrocyte NO efflux and S-nitrosoglutathione (GSNO) concentration were measured. RESULTS No significant differences were obtained in erythrocyte NO efflux and GSNO concentration in response to ACh or timolol when compared with the untreated erythrocytes of glaucoma patients. When comparing the same incubation conditions for erythrocyte suspensions between glaucoma patients and healthy subjects, those from glaucoma patients showed higher NO efflux in presence and absence of timolol, and higher values of GSNO in the presence of timolol. CONCLUSIONS We demonstrated that erythrocytes from glaucoma patients have similar availability to release NO both in absence and presence of timolol, and have higher GSNO values in presence of timolol.
Collapse
Affiliation(s)
- Rita Esteves
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Teresa Freitas
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Pedro Teixeira
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Patrícia Napoleão
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| | - Carlos Neves
- Faculdade de Medicina, Universidade de Lisboa, ISAMB, CECU Coordenator, ALM Clinical Director
| | - Carlota Saldanha
- Carlota Saldanha Lab, Instituto de Medicina Molecular, Instituto de Bioquímica, Faculdade de Medicina, Universidade de Lisboa. Lisboa, Portugal
| |
Collapse
|
18
|
Chen CL, Bojikian KD, Xin C, Wen JC, Gupta D, Zhang Q, Mudumbai RC, Johnstone MA, Chen PP, Wang RK. Repeatability and reproducibility of optic nerve head perfusion measurements using optical coherence tomography angiography. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:65002. [PMID: 27272095 PMCID: PMC4896902 DOI: 10.1117/1.jbo.21.6.065002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/19/2016] [Indexed: 05/29/2023]
Abstract
Optical coherence tomography angiography (OCTA) has increasingly become a clinically useful technique in ophthalmic imaging. We evaluate the repeatability and reproducibility of blood perfusion in the optic nerve head (ONH) measured using optical microangiography (OMAG)-based OCTA. Ten eyes from 10 healthy volunteers are recruited and scanned three times with a 68-kHz Cirrus HD-OCT 5000-based OMAG prototype system (Carl Zeiss Meditec Inc., Dublin, California) centered at the ONH involving two separate visits within six weeks. Vascular images are generated with OMAG processing by detecting the differences in OCT signals between consecutive B-scans acquired at the same retina location. ONH perfusion is quantified as flux, vessel area density, and normalized flux within the ONH for the prelaminar, lamina cribrosa, and the full ONH. Coefficient of variation (CV) and intraclass correlation coefficient (ICC) are used to evaluate intravisit and intervisit repeatability, and interobserver reproducibility. ONH perfusion measurements show high repeatability [CV≤3.7% (intravisit) and ≤5.2% (intervisit)] and interobserver reproducibility (ICC≤0.966) in all three layers by three metrics. OCTA provides a noninvasive method to visualize and quantify ONH perfusion in human eyes with excellent repeatability and reproducibility, which may add additional insight into ONH perfusion in clinical practice.
Collapse
Affiliation(s)
- Chieh-Li Chen
- University of Washington, Department of Bioengineering, 3720 15th Avenue NE, Seattle, Washington 98195, United States
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Karine D. Bojikian
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Chen Xin
- University of Washington, Department of Bioengineering, 3720 15th Avenue NE, Seattle, Washington 98195, United States
| | - Joanne C. Wen
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Divakar Gupta
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Qinqin Zhang
- University of Washington, Department of Bioengineering, 3720 15th Avenue NE, Seattle, Washington 98195, United States
| | - Raghu C. Mudumbai
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Murray A. Johnstone
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Philip P. Chen
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| | - Ruikang K. Wang
- University of Washington, Department of Bioengineering, 3720 15th Avenue NE, Seattle, Washington 98195, United States
- University of Washington, Department of Ophthalmology, 908 Jefferson Street, Seattle, Washington 98104, United States
| |
Collapse
|
19
|
Leontidis G, Al-Diri B, Hunter A. Summarising the retinal vascular calibres in healthy, diabetic and diabetic retinopathy eyes. Comput Biol Med 2016; 72:65-74. [DOI: 10.1016/j.compbiomed.2016.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/13/2016] [Accepted: 03/15/2016] [Indexed: 10/22/2022]
|
20
|
Saccà SC, Gandolfi S, Bagnis A, Manni G, Damonte G, Traverso CE, Izzotti A. The Outflow Pathway: A Tissue With Morphological and Functional Unity. J Cell Physiol 2016; 231:1876-93. [PMID: 26754581 DOI: 10.1002/jcp.25305] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/06/2016] [Indexed: 12/17/2022]
Abstract
The trabecular meshwork (TM) plays an important role in high-tension glaucomas. Indeed, the TM is a true organ, through which the aqueous humor flows from the anterior chamber to Schlemm's canal (SC). Until recently, the TM, which is constituted by endothelial-like cells, was described as a kind of passive filter. In reality, it is much more. The cells delineating the structures of the collagen framework of the TM are endowed with a cytoskeleton, and are thus able to change their shape. These cells also have the ability to secrete the extracellular matrix, which expresses proteins and cytokines, and are capable of phagocytosis and autophagy. The cytoskeleton is attached to the nuclear membrane and can, in millionths of a second, send signals to the nucleus in order to alter the expression of genes in an attempt to adapt to biomechanical insult. Oxidative stress, as happens in aging, has a deleterious effect on the TM, leading eventually to cell decay, tissue malfunction, subclinical inflammation, changes in the extracellular matrix and cytoskeleton, altered motility, reduced outflow facility, and (ultimately) increased IOP. TM failure is the most relevant factor in the cascade of events triggering apoptosis in the inner retinal layers, including ganglion cells. J. Cell. Physiol. 231: 1876-1893, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Sergio Claudio Saccà
- Department of Neuroscience and Sense Organs, Ophthalmology Unit, IRCCS San Martino University Hospital, San Martino Hospital, Genoa, Italy
| | - Stefano Gandolfi
- Department of Biological, Biotechnological and Translational Sciences, Ophthalmology Unit, University of Parma, Parma, Italy
| | - Alessandro Bagnis
- Department of Neuroscience and Sense Organs, Eye Clinic, University of Genoa, Genoa, Italy
| | - Gianluca Manni
- Department of Clinical Science and Translational Medicine, University Tor Vergata, Rome, Italy
| | - Gianluca Damonte
- Department of Experimental Medicine, Section of Biochemistry and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - Carlo Enrico Traverso
- Department of Neuroscience and Sense Organs, Eye Clinic, University of Genoa, Genoa, Italy
| | - Alberto Izzotti
- Department of Health Sciences, Mutagenesis Unit, IRCCS San Martino University Hospital, IST National Institute for Cancer Research, University of Genoa, Genoa, Italy
| |
Collapse
|
21
|
Ab Hamid F, Che Azemin MZ, Salam A, Aminuddin A, Mohd Daud N, Zahari I. Retinal Vasculature Fractal Dimension Measures Vessel Density. Curr Eye Res 2015; 41:823-31. [DOI: 10.3109/02713683.2015.1056375] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Fadilah Ab Hamid
- Department of Optometry & Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia,
| | - Mohd Zulfaezal Che Azemin
- Department of Optometry & Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia,
| | - Adzura Salam
- Department of Ophthalmology, Faculty of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia and
| | - Amilia Aminuddin
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Norsyazwani Mohd Daud
- Department of Optometry & Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia,
| | - Ilyanoon Zahari
- Department of Optometry & Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia,
| |
Collapse
|
22
|
Retinal vascular caliber between eyes with asymmetric glaucoma. Graefes Arch Clin Exp Ophthalmol 2015; 253:583-9. [PMID: 25795058 DOI: 10.1007/s00417-014-2895-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 11/19/2014] [Accepted: 12/12/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To compare differences in retinal arterial and venular caliber (RAC and RVC respectively) between fellow eyes with glaucoma of asymmetric severity. METHODS We included subjects with bilateral primary glaucoma that had vertical cup-disc ratios (VCDR) >0.2 between both eyes, or visual field (VF) mean deviation (MD) >6.0 decibels (dB) between both eyes. RESULTS Among 158 subjects, the average RAC in glaucoma eyes was 131.5 ± 17.8 μm vs 141.6 ± 18.8 μm in fellow eyes with mild disease (p < 0.001). RVCs in glaucoma eyes were 201.0 ± 21.4 μm vs 211.7 ± 25.3 μm in fellow eyes with mild disease (p < 0.001). This relationship held in clustered linear regression models adjusted for age, gender, vascular risk factors, visual acuity, axial length, and intraocular pressure, with RVCs narrower in eyes with worse disease vs mild disease. Eyes with worse disease had greater VCDR (0.9 ± 0.1 vs 0.7 ± 0.1, p < 0.001), and worse VF MD (-18.5 ± 8.6 vs -6.6 ± 5.6, p < 0.001). CONCLUSION In glaucoma with asymmetric severity between fellow eyes, retinal vascular caliber is less in the eye with more severe disease.
Collapse
|
23
|
Miri S, Shrier EM, Glazman S, Ding Y, Selesnick I, Kozlowski PB, Bodis-Wollner I. The avascular zone and neuronal remodeling of the fovea in Parkinson disease. Ann Clin Transl Neurol 2015; 2:196-201. [PMID: 25750923 PMCID: PMC4338959 DOI: 10.1002/acn3.146] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 11/11/2022] Open
Abstract
Inner foveal thinning and intracellular alpha-synuclein were demonstrated in the retina in Parkinson disease. While pathognomonic alpha-synuclein is associated with embryonic dopaminergic (DA) neurons, postmortem studies in the nervous system and retina show prominent effect also in non-DA neurons. We evaluated foveal capillaries and foveal thickness in 23 Parkinson disease subjects and 13 healthy controls using retinal fluorescein angiography and optical coherence tomography. The size of the foveal avascular zone inversely correlates with foveal thinning. Foveal thinning highly correlates with motor impairment and also disease duration. Quantifying capillary and neuronal remodeling could serve as biological markers.
Collapse
Affiliation(s)
- Shahnaz Miri
- Department of Neurology, SUNY Downstate Medical Center Brooklyn, New York, 11203
| | - Eric M Shrier
- Department of Ophthalmology, SUNY Downstate Medical Center Brooklyn, New York, 11203 ; SUNY Eye Institute Brooklyn, New York
| | - Sofya Glazman
- Department of Neurology, SUNY Downstate Medical Center Brooklyn, New York, 11203
| | - Yin Ding
- New York University New York City, New York
| | | | - Piotr B Kozlowski
- Neuromedlab Staten Island, NY, 10314 ; Touro College of the Osteopathic Medicine New York City, New York, 10027
| | - Ivan Bodis-Wollner
- Department of Neurology, SUNY Downstate Medical Center Brooklyn, New York, 11203 ; Department of Ophthalmology, SUNY Downstate Medical Center Brooklyn, New York, 11203 ; SUNY Eye Institute Brooklyn, New York
| |
Collapse
|
24
|
Pinhas A, Razeen M, Dubow M, Gan A, Chui TY, Shah N, Mehta M, Gentile RC, Weitz R, Walsh JB, Sulai YN, Carroll J, Dubra A, Rosen RB. Assessment of perfused foveal microvascular density and identification of nonperfused capillaries in healthy and vasculopathic eyes. Invest Ophthalmol Vis Sci 2014; 55:8056-66. [PMID: 25414179 DOI: 10.1167/iovs.14-15136] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To analyze the foveal microvasculature of young healthy eyes and older vasculopathic eyes, imaged using in vivo adaptive optics scanning light ophthalmoscope fluorescein angiography (AOSLO FA). METHODS AOSLO FA imaging of the superficial retinal microvasculature within an 800-μm radius from the foveal center was performed using simultaneous confocal infrared (IR) reflectance (790 nm) and fluorescence (488 nm) channels. Corresponding IR structural and FA perfusion maps were compared with each other to identify nonperfused capillaries adjacent to the foveal avascular zone. Microvascular densities were calculated from skeletonized FA perfusion maps. RESULTS Sixteen healthy adults (26 eyes; mean age 25 years, range, 21-29) and six patients with a retinal vasculopathy (six eyes; mean age 55 years, range, 44-70) were imaged. At least one nonperfused capillary was observed in five of the 16 healthy nonfellow eyes and in four of the six vasculopathic eyes. Compared with healthy eyes, capillary nonperfusion in the vasculopathic eyes was more extensive. Microvascular density of the 16 healthy nonfellow eyes was 42.0 ± 4.2 mm(-1) (range, 33-50 mm(-1)). All six vasculopathic eyes had decreased microvascular densities. CONCLUSIONS AOSLO FA provides an in vivo method for estimating foveal microvascular density and reveals occult nonperfused retinal capillaries. Nonperfused capillaries in healthy young adults may represent a normal variation and/or an early sign of pathology. Although limited, the normative data presented here is a step toward developing clinically useful microvascular parameters for ocular and/or systemic diseases.
Collapse
Affiliation(s)
- Alexander Pinhas
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Moataz Razeen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Alexandria Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Michael Dubow
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Alexander Gan
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Toco Y Chui
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Nishit Shah
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Mitul Mehta
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Ronald C Gentile
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Department of Ophthalmology, Winthrop-University Hospital, Mineola, New York, United States
| | - Rishard Weitz
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Joseph B Walsh
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Yusufu N Sulai
- The Institute of Optics, University of Rochester, Rochester, New York, United States
| | - Joseph Carroll
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Alfredo Dubra
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Richard B Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States Icahn School of Medicine at Mount Sinai, New York, New York, United States
| |
Collapse
|
25
|
Hui F, Nguyen CTO, Bedggood PA, He Z, Fish RL, Gurrell R, Vingrys AJ, Bui BV. Quantitative spatial and temporal analysis of fluorescein angiography dynamics in the eye. PLoS One 2014; 9:e111330. [PMID: 25365578 PMCID: PMC4218721 DOI: 10.1371/journal.pone.0111330] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/22/2014] [Indexed: 12/25/2022] Open
Abstract
Purpose We describe a novel approach to analyze fluorescein angiography to investigate fluorescein flow dynamics in the rat posterior retina as well as identify abnormal areas following laser photocoagulation. Methods Experiments were undertaken in adult Long Evans rats. Using a rodent retinal camera, videos were acquired at 30 frames per second for 30 seconds following intravenous introduction of sodium fluorescein in a group of control animals (n = 14). Videos were image registered and analyzed using principle components analysis across all pixels in the field. This returns fluorescence intensity profiles from which, the half-rise (time to 50% brightness), half-fall (time for 50% decay) back to an offset (plateau level of fluorescence). We applied this analysis to video fluorescein angiography data collected 30 minutes following laser photocoagulation in a separate group of rats (n = 7). Results Pixel-by-pixel analysis of video angiography clearly delineates differences in the temporal profiles of arteries, veins and capillaries in the posterior retina. We find no difference in half-rise, half-fall or offset amongst the four quadrants (inferior, nasal, superior, temporal). We also found little difference with eccentricity. By expressing the parameters at each pixel as a function of the number of standard deviation from the average of the entire field, we could clearly identify the spatial extent of the laser injury. Conclusions This simple registration and analysis provides a way to monitor the size of vascular injury, to highlight areas of subtle vascular leakage and to quantify vascular dynamics not possible using current fluorescein angiography approaches. This can be applied in both laboratory and clinical settings for in vivo dynamic fluorescent imaging of vasculature.
Collapse
Affiliation(s)
- Flora Hui
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Christine T. O. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Phillip A. Bedggood
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Rebecca L. Fish
- Neusentis, Pfizer Research and Development, Grant Park Science Park, Cambridge, United Kingdom
| | - Rachel Gurrell
- Neusentis, Pfizer Research and Development, Grant Park Science Park, Cambridge, United Kingdom
| | - Algis J. Vingrys
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Bang V. Bui
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
| |
Collapse
|
26
|
Kagemann L, Wang B, Wollstein G, Ishikawa H, Nevins JE, Nadler Z, Sigal IA, Bilonick RA, Schuman JS. IOP elevation reduces Schlemm's canal cross-sectional area. Invest Ophthalmol Vis Sci 2014; 55:1805-9. [PMID: 24526436 DOI: 10.1167/iovs.13-13264] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Previously, we demonstrated reduced Schlemm's canal cross-sectional area (SC-CSA) with increased perfusion pressure in a cadaveric flow model. The purpose of the present study was to determine the effect of acute IOP elevation on SC-CSA in living human eyes. METHODS The temporal limbus of 27 eyes of 14 healthy subjects (10 male, 4 female, age 36 ± 13 years) was imaged by spectral-domain optical coherence tomography at baseline and with IOP elevation (ophthalmodynamometer set at 30-g force). Intraocular pressure was measured at baseline and with IOP elevation by Goldmann applanation tonometry. Vascular landmarks were used to identify corresponding locations in baseline and IOP elevation scan volumes. Schlemm's canal CSA at five locations within a 1-mm length of SC was measured in ImageJ as described previously. A linear mixed-effects model quantified the effect of IOP elevation on SC-CSA. RESULTS The mean IOP increase was 189%, and the mean SC-CSA decrease was 32% (P < 0.001). The estimate (95% confidence interval) for SC-CSA response to IOP change was -66.6 (-80.6 to -52.7) μm(2)/mm Hg. CONCLUSIONS Acute IOP elevation significantly reduces SC-CSA in healthy eyes. Acute dynamic response to IOP elevation may be a useful future characterization of ocular health in the management of glaucoma.
Collapse
Affiliation(s)
- Larry Kagemann
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Kagemann L, Nevins JE, Jan NJ, Wollstein G, Ishikawa H, Kagemann J, Sigal IA, Nadler Z, Ling Y, Schuman JS. Characterisation of Schlemm's canal cross-sectional area. Br J Ophthalmol 2014; 98 Suppl 2:ii10-4. [PMID: 24590558 PMCID: PMC4208345 DOI: 10.1136/bjophthalmol-2013-304629] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose To compare three methods of Schlemm's canal (SC) cross-sectional area (CSA) measurement. Methods Ten eyes (10 healthy volunteers) were imaged three times using spectral-domain optical coherence tomography (Cirrus HD-OCT, Zeiss, Dublin, California, USA). Aqueous outflow vascular structures and SC collector channel ostia were used as landmarks to identify a reference location within the limbus. SC CSA was assessed within a 1 mm segment (±15 frames of the reference, 31 frames in all) by three techniques. (1) Using a random number table, SC CSA in five random frames from the set of 31 surrounding the reference were measured and averaged. (2) The most easily visualised SC location (subjective) was measured, and (3) SC CSA was measured in all 31 consecutive B-scans, and averaged. (comprehensive average, gold standard). Subjective and random CSAs were compared with the comprehensive by general estimating equation modelling, and structural equation modelling quantified agreement. Results The average from five random locations (4175±1045 µm2) was not significantly different than that obtained from the gold standard comprehensive assessment (4064±1308 µm2, p=0.6537). Subjectively located SC CSA (7614±2162 µm2) was significantly larger than the comprehensive gold standard SC CSA (p<0.0001). The average of five random frames produced significantly less bias than did subjective location, yielding a calibration line crossing the ‘no-bias’ line. Discussion Subjectively located SC CSA measurements produce high estimates of SC CSA. SC assessed by measuring five random locations estimate CSA was similar to the gold standard estimate.
Collapse
Affiliation(s)
- Larry Kagemann
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica E Nevins
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Ninj-Jiun Jan
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Gadi Wollstein
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Ian A Sigal
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Zach Nadler
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yun Ling
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Joel S Schuman
- Department of Ophthalmology, UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
28
|
Arteriovenous passage times and visual field progression in normal tension glaucoma. ScientificWorldJournal 2013; 2013:726912. [PMID: 24282387 PMCID: PMC3824313 DOI: 10.1155/2013/726912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 09/08/2013] [Indexed: 11/19/2022] Open
Abstract
Purpose. Fluorescein angiographic studies revealed prolonged arteriovenous passage (AVP) times and increased fluorescein filling defects in normal tension glaucoma (NTG) compared to healthy controls. The purpose of this study was to correlate baseline AVP and fluorescein filling defects with visual field progression in patients with NTG. Patients and Methods. Patients with a follow-up period of at least 3 years and at least 4 visual field examinations were included in this retrospective study. Fluorescein angiography was performed at baseline using a confocal scanning laser ophthalmoscope (SLO, Rodenstock Instr.); fluorescein filling defects and AVP were measured by digital image analysis and dye dilution curves (25 Hz). Visual field progression was evaluated using regression analysis of the MD (Humphrey-Zeiss, SITA-24-2, MD progression per year (dB/year)). 72 patients with NTG were included, 44 patients in study 1 (fluorescein filling defects) and 28 patients in study 2 (AVP). Results. In study 1 (mean follow-up 6.6 ± 1.9 years, 10 ± 5 visual field tests), MD progression per year (−0.51 ± 0.59 dB/year) was significantly correlated to the age (P = 0.04, r = -0.29) but not to fluorescein filling defects, IOP, or MD at baseline. In study 2 (mean follow-up 6.6 ± 2.2 years, 10 ± 5 visual field tests), MD progression per year (−0.45 ± 0.51 dB/year) was significantly correlated to AVP (P = 0.03, r = 0.39) but not to age, IOP, or MD at baseline. Conclusion. Longer AVP times at baseline are correlated to visual field progression in NTG. Impaired retinal blood flow seems to be an important factor for glaucoma progression.
Collapse
|
29
|
Ikram MK, Ong YT, Cheung CY, Wong TY. Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives. Ophthalmologica 2013; 229:125-36. [DOI: 10.1159/000342158] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 07/01/2012] [Indexed: 11/19/2022]
|
30
|
Kawasaki R, Wang JJ, Rochtchina E, Lee AJ, Wong TY, Mitchell P. Retinal vessel caliber is associated with the 10-year incidence of glaucoma: the Blue Mountains Eye Study. Ophthalmology 2012; 120:84-90. [PMID: 23062656 DOI: 10.1016/j.ophtha.2012.07.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/14/2012] [Accepted: 07/05/2012] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To examine associations between quantitatively measured retinal vessel caliber and the 10-year incidence of primary open-angle glaucoma (OAG). DESIGN Population-based cohort study. PARTICIPANTS The Blue Mountains Eye Study examined 3654 persons at baseline and 2461 persons at either 5 years, 10 years, or both times. After excluding 44 subjects with OAG at baseline, 2417 participants at risk of OAG at the 5- or 10-year examinations were included. METHODS Retinal vessel calibers of baseline retinal photographs were measured using a computer-based program and summarized as central retinal artery and vein equivalents (CRAE, CRVE). Incident OAG was defined as the development of typical glaucomatous visual field loss combined with matching optic disc rim thinning and an enlarged cup-to-disc (C:D) ratio of >0.7 or C:D asymmetry between the 2 eyes (≥0.3) at either the 5- or 10-year examination. Generalized estimating equation models were used to account for correlation between eyes while adjusting for glaucoma risk characteristics including intraocular pressure (IOP) or ocular perfusion pressure (OPP). MAIN OUTCOME MEASURES We assessed the 10-year incidence of OAG. RESULTS There were 82 persons (104 eyes) who developed incident OAG over the 10-year follow-up. After adjusting for age, sex, family history of glaucoma, smoking, diabetes, hypertension, hypercholesterolemia, body mass index, spherical equivalent refraction, and C:D ratio, narrower CRAE was associated with higher risk of incident OAG (adjusted odds ratio [OR], 1.77; 95% confidence interval [CI], 1.12-2.79, per standard deviation decrease in CRAE). This association persisted after further adjustment for IOP (adjusted OR, 1.87; 95% CI, 1.14-3.05) or OPP (adjusted OR, 1.76; 95% CI, 1.11-2.78), and remained significant when analyses were confined to eyes with IOP<20 mmHg and C:D ratio<0.6 at baseline. There were no independent associations between CRVE and incident OAG. CONCLUSIONS Retinal arteriolar narrowing, quantitatively measured from retinal photographs, was associated with long-term risk of OAG. These data support the concept that early vascular changes are involved in the pathogenesis of OAG and suggest that computer-based measurements of retinal vessel caliber may be useful to identify people with an increased risk of developing the clinical stage of glaucoma. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Collapse
Affiliation(s)
- Ryo Kawasaki
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Australia
| | | | | | | | | | | |
Collapse
|
31
|
Wang Y, Fawzi AA, Varma R, Sadun AA, Zhang X, Tan O, Izatt JA, Huang D. Pilot study of optical coherence tomography measurement of retinal blood flow in retinal and optic nerve diseases. Invest Ophthalmol Vis Sci 2011; 52:840-5. [PMID: 21051715 DOI: 10.1167/iovs.10-5985] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate blood flow changes in retinal and optic nerve diseases with Doppler Fourier domain optical coherence tomography (OCT). METHODS Sixty-two participants were divided into five groups: normal, glaucoma, nonarteritic ischemic optic neuropathy (NAION), treated proliferative diabetic retinopathy (PDR), and branch retinal vein occlusion (BRVO). Doppler OCT was used to scan concentric circles of 3.4- and 3.75-mm diameters around the optic nerve head. Flow in retinal veins was calculated from the OCT velocity profiles. Arterial and venous diameters were measured from OCT Doppler and reflectance images. RESULTS Total retinal blood flow in normal subjects averaged 47.6 μL/min. The coefficient of variation of repeated measurements was 11% in normal eyes and 14% in diseased eyes. Eyes with glaucoma, NAION, treated PDR, and BRVO had significantly decreased retinal blood flow compared with normal eyes (P < 0.001). In glaucoma patients, the decrease in blood flow was highly correlated with the severity of visual field loss (P = 0.003). In NAION and BRVO patients, the hemisphere with more severe disease also had lower blood flow. CONCLUSIONS Doppler OCT retinal blood flow measurements showed good repeatability and excellent correlation with visual field and clinical presentations. This approach could enhance our understanding of retinal and optic nerve diseases and facilitate the development of new therapies.
Collapse
Affiliation(s)
- Yimin Wang
- Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Retinal vessel diameter, retinal nerve fiber layer thickness, and intraocular pressure in korean patients with normal-tension glaucoma. Am J Ophthalmol 2011; 151:100-105.e1. [PMID: 21094935 DOI: 10.1016/j.ajo.2010.07.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 07/20/2010] [Accepted: 07/20/2010] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the retinal vessel diameter and evaluate the relationship of the retinal nerve fiber layer (RNFL) thickness with retinal vessel diameter and intraocular pressure (IOP) in patients with normal-tension glaucoma (NTG). DESIGN A prospective, cross-sectional study. METHODS This study included 60 previously untreated patients with NTG (60 eyes) and 45 age- and sex-matched healthy controls (45 eyes) that had no history of systemic vascular disease at a single institution. The diameters of the central retinal arteries and veins were measured on retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr-Hubbard formula. The RNFL thickness was measured using Stratus optical coherence tomography. RESULTS The mean central retinal arteriolar (P = .000) and venular (P = .000) diameters were significantly smaller in the eyes with NTG than in the normal eyes. Multivariate linear regression analysis demonstrated a significant positive correlation between the RNFL thickness and CRAE (P = .014), and a negative correlation between the RNFL thickness and IOP (P = .005) in the eyes with NTG. However, there was no significant correlation between the RNFL thickness and the independent variables in the control group (P = .112). CONCLUSION The patients with NTG had smaller diameters of the central retinal vessels than the normal subjects. Both IOP and CRAE were significantly associated with RNFL thickness in the patients with NTG. Our results suggest that narrower retinal vessels and higher IOP may be related to the thinning of the RNFL in patients with NTG.
Collapse
|
33
|
Walshe TE, Connell P, Cryan L, Ferguson G, O'Brien C, Cahill PA. The role of pulsatile flow in controlling microvascular retinal endothelial and pericyte cell apoptosis and proliferation. Cardiovasc Res 2010; 89:661-70. [PMID: 21030535 DOI: 10.1093/cvr/cvq341] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Aberrant retinal blood flow is a hallmark of various retinopathies and may be a causative factor in the pathology associated with these conditions. We examined the effects of pulsatile flow on bovine retinal endothelial cell (BREC) and bovine retinal pericyte (BRP) apoptosis and proliferation. METHODS AND RESULTS Co-cultured BRECs and BRPs were exposed to low (0.3 mL/min) or high (25 mL/min) pulsatile flow for 72 h using a perfused transcapillary culture system. Pulsatile flow increased BREC nitric oxide synthase (eNOS) and cyclooxygenase-2 (COX-2) expression and activity concomitant with a significant decrease in pre-pro-endothelin-1 (ET-1) mRNA and peptide. BREC apoptosis was significantly attenuated following exposure to high flow. The inhibition of NOS, COX, and ET receptors significantly reduced the pro-survival effects of flow on BREC. In contrast, BRP apoptosis was significantly enhanced following exposure to high flow. The inhibition of COX and ET receptors significantly attenuated the high flow-induced increase in BRP apoptosis when compared with untreated controls. Treatment of static BREC with NO donor (S-nitroso-N-acetylpenicillamine, SNAP), ET-1, or iloprost inhibited serum deprivation-induced apoptosis, whereas treatment of BRP with ET-1 and iloprost, but not SNAP, was ineffective. High pulsatile flow decreased BRP proliferation, in the absence of any changes in BREC proliferation. CONCLUSION Increased pulsatile flow promotes BREC survival and enhances BRP apoptosis through the activation of endothelial-derived vasoactive substances. Altered pulsatile flow does not alter BREC proliferation in co-culture with BRP, whereas BRP proliferation was significantly decreased at high flow rates. These interactions have important implications for vessel growth and regression during retinal vascular pathogenesis.
Collapse
Affiliation(s)
- Tony E Walshe
- Vascular Health Research Centre, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
| | | | | | | | | | | |
Collapse
|
34
|
Kong XM, Sun XH, Yu DY, Guo WY, Yu XB. Study of retinal microvessels in a Rhesus monkey model of chronic high intraocular pressure. Vet Ophthalmol 2008; 11:321-6. [DOI: 10.1111/j.1463-5224.2008.00653.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
35
|
Berisha F, Feke GT, Hirose T, McMeel JW, Pasquale LR. Retinal blood flow and nerve fiber layer measurements in early-stage open-angle glaucoma. Am J Ophthalmol 2008; 146:466-472. [PMID: 18571616 DOI: 10.1016/j.ajo.2008.04.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2007] [Revised: 04/21/2008] [Accepted: 04/22/2008] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the relationship between retinal circulatory abnormalities and retinal nerve fiber layer (RNFL) thinning in early-stage open-angle glaucoma (OAG) to help elucidate the mechanisms underlying the development of glaucomatous optic neuropathy. DESIGN Prospective cross-sectional. METHODS Twelve patients with early OAG and a known maximum untreated intraocular pressure less than 22 mm Hg (age, 61.4 +/- 9.7 years; Humphrey visual field mean deviation -2.7 +/- 2.1) and eight age-matched healthy control subjects (age, 58.5 +/- 8.3 years) were included in the study. Blood column diameter, centerline blood speed, and retinal blood flow were measured in the major inferior temporal retinal artery using a Canon laser Doppler blood flow instrument (CLBF 100; Canon, Tokyo, Japan). Peripapillary RNFL thickness was measured using a Stratus optical coherence tomography instrument. RESULTS On average, there were significant reductions in retinal blood speed (P = .009) and flow (P = .010) in OAG patients compared to controls. The RNFL was significantly thinner in the OAG patients compared to controls (P = .002). There were significant inverse correlations between retinal blood flow and average RNFL thickness and RNFL thickness in the inferior quadrant within the glaucoma group (Rsq = 0.50, P = .01; Rsq = 0.62, P = .003). CONCLUSION The results showed that a thinner RNFL was associated with a higher retinal blood flow in patients with early-stage OAG. The mechanisms underlying this phenomenon remain to be elucidated.
Collapse
Affiliation(s)
- Fatmire Berisha
- Schepens Retina Associates Foundation, One Autumn Street, Boston, MA 02215, USA
| | | | | | | | | |
Collapse
|
36
|
Prolonged retinal arteriovenous passage time is correlated to ocular perfusion pressure in normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol 2008; 246:1147-52. [DOI: 10.1007/s00417-008-0807-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 02/11/2008] [Accepted: 02/25/2008] [Indexed: 10/22/2022] Open
|
37
|
Abstract
During the last decade, the presumed etiology of glaucoma has moved from a pure pressure concept to a combined mechanical and vascular theory. Evidence of a localized vascular insufficiency leading to perfusion deficits of ocular structures, including the optic nerve head, the retina, the choroid, and the retrobulbar vessels, is now clear. This article evaluates the role of vasospasm as the primary cause of such a vascular failure. The role of both ocular and systemic vasospasms and their clinical correlations are discussed. At a cellular level, the function of the modulating role of the vascular endothelium is reviewed. Evidence of abnormalities of the vascular endothelium and its vasoactive peptides as a conduit for vasospasm is mounting. Herein lies exciting prospects for potential pharmacologic targets in future glaucoma management.
Collapse
|
38
|
Plange N, Kaup M, Huber K, Remky A, Arend O. Fluorescein filling defects of the optic nerve head in normal tension glaucoma, primary open-angle glaucoma, ocular hypertension and healthy controls. Ophthalmic Physiol Opt 2006; 26:26-32. [PMID: 16390479 DOI: 10.1111/j.1475-1313.2005.00349.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND To evaluate fluorescein filling defects of the optic nerve head in normal tension glaucoma (NTG), primary open-angle glaucoma (POAG), ocular hypertension (OHT) and controls. METHODS Forty patients with NTG (mean age 55 +/- 10 years), 40 patients with POAG (mean age 55 +/- 11 years), 40 patients with OHT (mean age 53 +/- 13 years), and 40 age-matched controls (mean age 54 +/- 11 years) were included in a prospective study. Video fluorescein angiograms were performed by means of a scanning laser ophthalmoscope. The extent of absolute filling defects of the optic nerve head was assessed (as a percentage of the disc area) using digital image analysis. Visual fields were tested by automatic static perimetry (Humphrey Field Analyzer, programme 24-2). RESULTS Absolute filling defects were significantly larger in patients with NTG (12.2 +/- 15.5%) and POAG (12.9 +/- 13.1%) compared to patients with OHT (1.2 +/- 3.6%) and healthy controls (0.1 +/- 0.5%) (p < 0.0001). The area under the receiver operating characteristic (ROC) curve was 0.806 for NTG vs healthy controls, and 0.812 for POAG vs OHT. Absolute filling defects are significantly correlated to the global indices mean deviation (r = -0.63, p < 0.0001), pattern standard deviation (r = 0.61, p < 0.0001), and corrected pattern standard deviation (r = 0.62, p < 0.0001) and significantly correlated to horizontal (r = 0.50, p < 0.0001) and vertical (r = 0.53, p < 0.0001) cup-to-disc-ratios. CONCLUSIONS Fluorescein filling defects of the optic disc representing capillary dropout are present in NTG and POAG. The extent of these filling defects is correlated to visual field loss and morphological damage. Fluorescein angiography may be useful in the diagnosis and management of NTG and POAG.
Collapse
Affiliation(s)
- Niklas Plange
- Augenklinik des Universitätsklinikum Aachen, Germany.
| | | | | | | | | |
Collapse
|
39
|
|
40
|
Huber K, Plange N, Remky A, Arend O. Comparison of colour Doppler imaging and retinal scanning laser fluorescein angiography in healthy volunteers and normal pressure glaucoma patients. ACTA ACUST UNITED AC 2004; 82:426-31. [PMID: 15291936 DOI: 10.1111/j.1395-3907.2004.00269.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To correlate retinal circulatory measurements using scanning laser fluorescein angiography and flow velocities of retrobulbar vessels measured by means of colour Doppler imaging. METHODS Fifteen patients with normal pressure glaucoma (NPG) and 15 healthy volunteers underwent colour Doppler imaging and fluorescein angiographic studies. Peak systolic velocities (PSVs), end-diastolic velocities (EDVs) and resistive indices (RIs) of the ophthalmic artery (OA) and central retinal artery were obtained. In the fluorescein angiograms arteriovenous passage time (AVP) was quantified by means of digital dye dilution curve analysis. RESULTS Arteriovenous passage time was significantly prolonged in NPG patients compared to healthy subjects (p = 0.0026). In the central retinal artery PSV (p = 0.023) and EDV (p < 0.0001) were significantly decreased and RI was increased (p < 0.0001) in patients with NPG. The EDV of the central retinal artery showed a significant correlation with AVP (EDV: r = - 0.53, p = 0.0023). The RI of the central retinal artery correlated significantly to AVP (RI: r = 0.63, p < 0.0001). The AVP did not correlate to EDV or PSV, nor to the RI measured in the ophthalmic artery. CONCLUSION Arteriovenous passage time, which represents blood flow in a vascular segment of artery, capillary bed and corresponding vein, was found to be correlated to the EDV and the RI of the central retinal artery. The combination of different techniques allows further interpretation of ocular circulatory responses.
Collapse
Affiliation(s)
- K Huber
- Department of Ophthalmology, University Hospital, Medical Faculty, Aachen University, Aachen, Germany.
| | | | | | | |
Collapse
|
41
|
Owen CG, Ellis TJ, Woodward EG. A comparison of manual and automated methods of measuring conjunctival vessel widths from photographic and digital images. Ophthalmic Physiol Opt 2004; 24:74-81. [PMID: 15005671 DOI: 10.1046/j.1475-1313.2003.00171.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We investigated the application of a fully automated computer algorithm for identifying vessels of the conjunctiva from their scleral surround, and compared measures of vessel width with established methods. Vessel widths at 101 locations (ranging from 20 to 140 microm), from 12 patients, were measured from film and digital images, using a variety of methods, and compared. Widths were measured manually, by semi-automated methods using grey level (densitometric) profiles taken from digital images, and by automated techniques set at different operating levels. Good intra-session repeatibility was obtained using the automated method with an operating sigma value of 3 pixels (16 microm) (mean difference 0.5 microm, 95% CI -8.5 to 9.4 microm) and manual calliper measurements from digitally created photographic slides (mean difference 0.4 microm, -9.3 to 10.1 microm). For comparison with other measures of width, the latter was used as the gold standard. Widths measured from film were slightly larger than those measured directly from digital images, although this effect was small (5 microm) for most vessels. Overall widths measured using the automated method, with a sigma value of 3 pixels, agreed best with the gold standard (inter-method repeatibility; mean difference 1.4 microm, -32.5 to 35.2 microm) although the automated method overestimated small widths (<40 microm) and underestimated larger vessel widths (>40 microm). Automated detection of vessels of the conjunctiva from digital images avoids manual and operator involved measures which are time consuming, and which preclude large patient studies. The resulting data may help in monitoring the vascular response of the conjunctiva to surgical or pharmacological intervention, and in describing vascular changes in response to ocular or systemic disease. The application of this algorithm to the study of retinal vessels is yet to be realised.
Collapse
Affiliation(s)
- Christopher G Owen
- Department of Community Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK.
| | | | | |
Collapse
|
42
|
Kaup M, Plange N, Niegel M, Remky A, Arend O. Effects of brinzolamide on ocular haemodynamics in healthy volunteers. Br J Ophthalmol 2004; 88:257-62. [PMID: 14736787 PMCID: PMC1771998 DOI: 10.1136/bjo.2003.021485] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM A prospective, randomised study to evaluate effects of brinzolamide on ocular haemodynamics in healthy volunteers. METHODS 30 volunteers (12 men, 18 women; 28.3 (SD 7.8) years) were prospectively randomised to either brinzolamide or placebo during a 2 week double masked treatment trial. Examinations were performed at baseline and after 2 weeks of treatment. Intraocular pressure was measured and automatic static perimetry (Humphrey field analyser, 24-2) and contrast sensitivity (CSV 1000, Vector Vision) were performed. Retrobulbar blood flow velocities (peak systolic and end diastolic velocity) and resistive indices (RI) of ophthalmic artery, central retinal artery and of temporal and nasal short posterior ciliary arteries were measured by colour Doppler imaging (Sonoline Sienna Siemens). In video fluorescein angiograms (scanning laser ophthalmoscope, Rodenstock) arteriovenous passage time (AVP, dilution curves) and peripapillary diameters of retinal arterioles and venules were measured by means of digital image analysis. RESULTS Intraocular pressure was significantly decreased by brinzolamide (p<0.0001). Neither brinzolamide nor placebo changed visual field global indices after treatment. Contrast sensitivity at 3 cycles per degree was significantly higher in the placebo group (p<0.05). Apart from an increase of RI in ophthalmic artery under placebo treatment (p<0.05) there was no effect in retrobulbar haemodynamics in both groups. Brinzolamide therapy alone resulted in a significant reduction of AVP compared to baseline (p<0.05), while peripapillary retinal vessels diameters remained unaffected. CONCLUSIONS Apart from the expected decrease of intraocular pressure brinzolamide showed no significant change in retrobulbar haemodynamics, but a significant shortening of AVP. Since in glaucoma AVP is prolonged indicating vascular dysfunction this effect might be beneficial in glaucoma therapy.
Collapse
Affiliation(s)
- M Kaup
- Department of Ophthalmology, Aachen University, Aachen, Germany
| | | | | | | | | |
Collapse
|
43
|
Remky A, Plange N, Klok J, Arend O. Retinale Gefäßdurchmesser bei Glaukom. SPEKTRUM DER AUGENHEILKUNDE 2004. [DOI: 10.1007/bf03163271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Jonas JB, Harazny J, Budde WM, Mardin CY, Papastathopoulos KI, Michelson G. Optic disc morphometry correlated with confocal laser scanning Doppler flowmetry measurements in normal-pressure glaucoma. J Glaucoma 2003; 12:260-5. [PMID: 12782846 DOI: 10.1097/00061198-200306000-00014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the relationship between morphologic optic disc parameters and hemodynamic parameters as measured by confocal laser scanning Doppler flowmetry in patients with normal-pressure glaucoma. METHODS The study included 91 eyes of 54 patients with normal-pressure glaucoma (mean age: 57.7 +/- 9.8 years), and 136 eyes of 77 age-adjusted normal controls. Color stereo optic disc photographs were morphometrically examined, and confocal laser scanning flowmetry (Heidelberg Retinal Flowmeter) in the neuroretinal rim inside of the optic disc, and in the retina close to the temporal and nasal border of the optic nerve head was performed. RESULTS Mean confocal laser scanning flowmetric measurements in the neuroretinal rim, temporal parapapillary retina, and nasal parapapillary retina were significantly (P<0.03) lower in the normal-pressure glaucoma group than in the age-adjusted control group. Correspondingly, mean confocal laser scanning flowmetric measurements within the neuroretinal rim decreased significantly, with relatively low correlation coefficients, decreasing neuroretinal rim area (P = 0.016; correlation coefficient r2 = 0.026), and increasing mean visual field defect (P = 0.011; r2 = 0.029). Measurements were statistically independent of alpha zone (P = 0.38; r2 = 0.004) and beta zone (P = 0.57; r2 = 0.002) of parapapillary atrophy. CONCLUSIONS Confocal laser scanning flowmetric measurements within the neuroretinal rim were lower in eyes with normal-pressure glaucoma than in age-matched normal eyes. Confocal laser scanning flowmetric measurements decrease with increasing glaucomatous optic nerve damage. There is, however, a marked variability preventing a clear relationship between stage of glaucoma and decrease in confocal laser scanning flowmetric measurements. The correlation between parapapillary atrophy and confocal laser scanning flowmetric measurements is not statistically significant in normal-pressure glaucoma.
Collapse
Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
| | | | | | | | | | | |
Collapse
|