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Smith JD, Bisignano K, Harrison WW. Test-retest repeatability in macular retinal oximetry. Clin Exp Optom 2023:1-6. [PMID: 37844335 PMCID: PMC11018714 DOI: 10.1080/08164622.2023.2261928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
CLINICAL RELEVANCE Evaluation of retinal macular oxygen saturation in healthy controls can aid in understanding the pathological changes seen in similar locations of those with vascular diseases like diabetes. BACKGROUND The aim of this study was to determine the test-retest repeatability of localised retinal oximetry measurements in the macula on the Zilia Oximeter within healthy subjects of different races, 18-40 years old. Oxygen saturation was measured between three time points within the same locations of the right eye. METHODS Twenty seven subjects were included (aged 26.3 ± 3.6 years). All were confirmed to have healthy retinas and at least 6/9 vision. Oximetry measurements were taken using the Zilia to acquire local oxygen saturation measurements (300 µm diameter) at four points 3.1 degrees from the fovea in the superior/temporal, superior/nasal, inferior/temporal, and inferior/nasal locations. Oximetry measurements were taken twice on the same day 20 minutes apart and then again 1-2 weeks later. Oximetry data was analysed with intraclass correlation between visits. To assess intrasubject repeatability, the Bland-Altman repeatability coefficient and coefficient of variation were calculated. RESULTS Average Intraclass correlation for the three acquisition times of the right eye was 0.78. The averaged intrasubject repeatability coefficient for the three acquisition times was 8.4. The averaged coefficient of variation was 5.4%. CONCLUSION The Zilia oximeter has good macular test-retest repeatability; however, multiple measurements may be needed to ensure accuracy.
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Affiliation(s)
- Jennyffer D Smith
- Department of Optometry, University of Houston College of Optometry, Houston, TX, USA
| | - Kelly Bisignano
- Department of Optometry, University of Houston College of Optometry, Houston, TX, USA
| | - Wendy W Harrison
- Department of Optometry, University of Houston College of Optometry, Houston, TX, USA
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Gullaksen S, Vernstrøm L, Sørensen SS, Funck KL, Petersen L, Bek T, Poulsen PL, Laugesen E. Effects of semaglutide and empagliflozin on oxygenation, vascular autoregulation, and central thickness of the retina in people with type 2 diabetes: A prespecified secondary analysis of a randomised clinical trial. J Diabetes Complications 2023; 37:108472. [PMID: 37062189 DOI: 10.1016/j.jdiacomp.2023.108472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/18/2023]
Abstract
AIMS Semaglutide and empagliflozin have shown cardiovascular protection. In SUSTAIN-6, semaglutide was associated with an increased risk of diabetic retinopathy. We investigated whether changes in retinal oxygenation, retinal vascular autoregulation, and central retinal thickness are altered by semaglutide, empagliflozin or the combination. METHODS This study was a prespecified, secondary outcome from a randomised, 32 weeks partly placebo-controlled, partly open-label, clinical trial on the effects of semaglutide and empagliflozin on arterial stiffness and kidney oxygenation. A total of 120 participants with type 2 diabetes, established or high risk of cardiovascular disease and age ≥50 years were randomised into four parallel groups (semaglutide, empagliflozin, the combination or tablet placebo, n = 30 for each group). We primarily hypothesized that semaglutide would increase venular oxygenation. RESULTS We found no changes in retinal arteriolar, venular or venular-arteriolar oxygenation nor in retinal vessel diameter regardless of treatment group. Semaglutide increased central retinal thickness compared to placebo with ~1 % (3.8 μm 95 % CI [0.9;6.7], p = 0.009) with no changes in the empagliflozin or combination group. CONCLUSION Neither semaglutide, empagliflozin nor the combination alters markers of retinal function. The effect of semaglutide on central retinal thickness was small, but the clinical significance is uncertain.
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Affiliation(s)
- Søren Gullaksen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark; Steno Diabetes Center, Aarhus University Hospital, 8200 Aarhus N, Denmark.
| | - Liv Vernstrøm
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Steffen Skovgaard Sørensen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | | | - Line Petersen
- Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Per Løgstrup Poulsen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; Steno Diabetes Center, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark; Steno Diabetes Center, Aarhus University Hospital, 8200 Aarhus N, Denmark; Diagnostic Centre, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark
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3
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Zhou MJ, Shao JW, Pu J, Xiang ST, Liang Y, He Q, Su W, Liu C. An analysis of the correlation between diabetic retinopathy and preretinal oxygen tension using three-dimensional spoiled gradient-recalled echo sequence imaging. BMC Med Imaging 2022; 22:121. [PMID: 35790918 PMCID: PMC9258100 DOI: 10.1186/s12880-022-00846-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background The aims of this study were to evaluate the levels of preretinal oxygen tension in patients with diabetes who did not have hypertension by using three-dimensional spoiled gradient-recalled (3D-SPGR) echo sequence imaging and to explore the correlation between diabetic retinopathy (DR) and changes in preretinal oxygen tension. Method This study involved 15 patients with type 2 diabetes without hypertension, who were divided into a diabetic retinopathy (DR) group (n = 10 eyes) and a diabetic non-retinopathy (NDR) group (n = 20 eyes), according to the results of a fundus photography test. Another healthy control group (n = 14 eyes) also participated in the study. The preretinal vitreous optic disc area, nasal side, and temporal side signal intensity of the eyes was assessed before and after oxygen inhalation with the use of 3D-SPGR echo magnetic resonance imaging (MRI). The signal acquisition time was 10, 20, 30, 40, and 50 min after oxygen inhalation. Results The results showed that, in the DR and NDR groups, the preretinal vitreous oxygen tension increased rapidly at 10 min after oxygen inhalation and peaked at 30–40 min, and the increased slope of the DR group was higher than that of the NDR group. The oxygen tension of the preretinal vitreous gradually increased after oxygen inhalation, and the difference between the DR and NDR groups and the control group was statistically significant (P < 0.05). The preretinal vitreous oxygen tension was higher in the optic disc, temporal side, and nasal side in the NDR group than in the control group, and the difference was statistically significant (P < 0.05). The maximum slope ratios of the optic disc and the temporal side of the DR group were greater than those of the control group, and the difference was statistically significant (P < 0.05). Conclusion Three-dimensional-SPGR echo MRI sequencing technology is useful for detecting preretinal oxygen tension levels in patients with diabetes. It can be used as one of the functional and imaging observation indicators for the early diagnosis of DR.
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Affiliation(s)
- Min-Jie Zhou
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
| | - Ju-Wei Shao
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
| | - Jian Pu
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
| | - Shu-Tian Xiang
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
| | - Yi Liang
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
| | - Qian He
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China.
| | - Wei Su
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
| | - Cheng Liu
- Department of Radiology, Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, No.176 of Qingnian street, Wuhua District, Kunming, 650000, China
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Veiby NC, Simeunovic A, Heier M, Brunborg C, Saddique N, Moe MC, Dahl‐Jørgensen K, Petrovski G, Margeirsdottir HD. Retinal venular oxygen saturation is associated with non-proliferative diabetic retinopathy in young patients with type 1 diabetes. Acta Ophthalmol 2022; 100:388-394. [PMID: 34668632 DOI: 10.1111/aos.15018] [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: 04/14/2021] [Revised: 06/22/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the contribution of retinal vessel density (VD), central retinal vessel diameter and retinal oxygen (O2 ) saturation independently of other known risk factors in the development of non-proliferative diabetic retinopathy (NPDR). METHODS Macular optical coherence tomography angiography (OCTA), central retinal artery/vein equivalent diameter (CRAE/CRVE) measurements and retinal oximetry were performed in a cross-sectional study of 166 eyes from 166 individuals with type 1 diabetes (T1D) aged 14-30 years. Multiple logistic regression analysis was used to investigate whether O2 saturation, retinal vessel diameters and vessel density in the deep capillary plexus (VD-DCP) were associated with NPDR, when adjusting for known risk factors. The individuals were allocated to one group without and one group with NPDR. RESULTS Multiple logistic regression analysis showed that age (OR = 1.25, 95% CI: 1.04-1.49) and AV-difference in O2 saturation (OR = 0.85, 95% CI 0.77-0.93) were significantly associated with NPDR. CONCLUSION Our findings suggest that age and lower AV-O2 saturation difference contribute to explaining the grade of NPDR independently of other well-known risk factors. Reduced delivery of O2 to the retinal tissue is associated with the development of NPDR in young patients with T1D and should be given appropriate weight in the risk stratification at early stages of the disease.
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Affiliation(s)
- Nina C.B.B. Veiby
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Aida Simeunovic
- Department of Paediatrics and adolescent Medicine Akershus University Hospital Lorenskog Norway
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Martin Heier
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Cathrine Brunborg
- Oslo Centre of Biostatistics and Epidemiology Oslo University Hospital Oslo Norway
| | - Naila Saddique
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Morten C. Moe
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
| | - Knut Dahl‐Jørgensen
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Goran Petrovski
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
| | - Hanna D. Margeirsdottir
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
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Wang XL, Cai FR, Gao YX, Zhang J, Zhang M. Changes and significance of retinal blood oxygen saturation and oxidative stress indexes in patients with diabetic retinopathy. World J Diabetes 2022; 13:408-416. [PMID: 35664547 PMCID: PMC9134027 DOI: 10.4239/wjd.v13.i5.408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/28/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a diabetic complication that can severely affect the patients’ vision, eventually leading to blindness. DR is the most important manifestation of diabetic micro-vasculopathy and is mainly related to the course of diabetes and the degree of blood glucose control, while the age of diabetes onset, sex, and type of diabetes have little influence on it.
AIM To explore the changes in blood oxygen saturation and oxidative stress indices of retinal vessels in patients with DR.
METHODS In total, 94 patients (94 eyes) with DR (DR group) diagnosed at Jianyang people’s Hospital between March 2019 and June 2020, and 100 volunteers (100 eyes) (control group) without eye diseases, were included in this study. Arterial and venous blood oxygen saturation, retinal arteriovenous vessel diameter, and serum oxidative stress indicators in the two groups were compared. Based on the stage of the disease, the DR group was divided into the simple DR and proliferative DR groups for stratified analysis.
RESULTS The oxygen saturation of the retinal vessels in the DR group was significantly higher than that in the control group (P < 0.05). The retinal vessel diameters between the DR and control groups were not significantly different. The serum malondialdehyde (MDA) and 8-hydroxydehydroguanosine (8-OHdG) levels in the DR group were significantly higher than those in the control group (P < 0.05). The serum superoxide dismutase (SOD) and reduced glutathione (GSH) levels in the DR group were significantly lower than those in the control group (P < 0.05). The oxygen saturation of the retinal vessels in the patients with proliferative DR was significantly higher than that in the patients with simple DR (P < 0.05). The retinal vessel diameter in patients with proliferative DR was not significantly different from that of patients with simple DR (P > 0.05). Serum MDA and 8-OHdG levels in patients with proliferative DR were significantly higher than those in patients with simple DR (P < 0.05). Serum SOD and GSH levels in patients with proliferative DR were significantly lower than those in patients with simple DR (P < 0.05).
CONCLUSION Increased blood oxygen saturation of retinal arteries and veins and increased oxidative stress damage in patients with DR may be associated with decreased retinal capillary permeability and arterial oxygen dispersion, possibly reflecting the patient’s condition.
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Affiliation(s)
- Xiao-Li Wang
- Department of Ophthalmology, Jianyang People’s Hospital of Sichuan Province, Jianyang 641400, Sichuan Province, China
| | - Fang-Rong Cai
- Department of Ophthalmology, Jianyang People’s Hospital of Sichuan Province, Jianyang 641400, Sichuan Province, China
| | - Yun-Xia Gao
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610000, Sichuan Province, China
| | - Jian Zhang
- Department of Ophthalmology, Jianyang People’s Hospital of Sichuan Province, Jianyang 641400, Sichuan Province, China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610000, Sichuan Province, China
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Heitmar R, Blann AD. Oxygen saturation in retinal vessels and their correlation with endothelial microparticles in diabetes mellitus and/or cardiovascular disease. Microvasc Res 2022; 142:104336. [PMID: 35143812 DOI: 10.1016/j.mvr.2022.104336] [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: 08/08/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Retinal oxygen supply is a critical requirement in ocular function, and when inadequate can lead to retinopathy. Endothelial dysfunction is a leading pathophysiology in diabetes and cardiovascular disease and may be assessed by endothelial microparticles (EMPs). We hypothesised links between retinal vessel oxygenation and EMPs, expecting these indices to be more adverse in those with both DM and CVD. METHODS Plasma from 34 patients with diabetes mellitus alone (DM), 40 with cardiovascular disease (CVD) alone and 36 with DM plus CVD was probed for EMPs by flow cytometry, but also for vascular markers soluble E-selectin (sEsel) and von Willebrand factor (vWf) (both ELISA). Retinal vessel fractal dimension, lacunarity, calibres and oxygen saturation were assessed from monochromatic and dual wavelength imaging respectively, intra-ocular pressure by was measured by rebound tonometry (I-CARE). RESULTS There was no difference in oxygenation (arterial p = 0.725, venous p = 0.264, arterio-venous difference 0.375) between the groups, but there were differences in EMPs (p = 0.049), vWf (p = 0.004) and sEsel (p = 0.032). In the entire cohort, and in diabetes alone, EMPs correlated with venous oxygenation (r = 0.24, p = 0.009 and r = 0.43, p = 0.011 respectively), while in DM + CVD, sEsel correlated with venous oxygenation (r = 0.55, p = 0.002) and with the arterial-venous difference (r = -0.63, p = 0.001). In multivariate regression analysis of vascular markers against retinal oximetry indices in the entire group, EMPs were positively linked to venous oxygenation (p = 0.037). CONCLUSIONS Despite differences in systemic markers of vascular function between DM, CVD and DM + CVD, there was no difference in arterial or venous retinal oxygenation, or their difference. However, EMPs were linked to venous oximetry, and may provide further insight into the mechanisms underlying diabetes and diabetic retinopathy.
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Affiliation(s)
- R Heitmar
- Aston University, School of Optometry, College of Health and Life Sciences, Aston Triangle, B4 7ET Birmingham, UK; Huddersfield University, Optometry and Vision Sciences, HD1 3DH Huddersfield, UK.
| | - A D Blann
- Huddersfield University, Optometry and Vision Sciences, HD1 3DH Huddersfield, UK; University of Birmingham Institute for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK
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Mlčák P, Chlup R, Kudlová P, Krystyník O, Král M, Kučerová V, Spurná J, Titzová S, Hübnerová P, Vláčil O, Šínová I, Karhanová M, Zapletalová J, Šín M. Retinal oxygen saturation is associated with HbA1c but not with short-term diabetes control, internal environment, smoking and mild retinopathy - ROXINEGLYD study. Acta Ophthalmol 2022; 100:e142-e149. [PMID: 33742561 DOI: 10.1111/aos.14853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 01/20/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Purpose of this prospective uncontrolled single-centre pilot study was to find an association of retinal oxygen saturation (SatO2 ) with acid-base balance (ABB), carboxyhaemoglobin concentration, current plasma glucose concentration (PG), mean PG and PG variability over the last 72 hr, haemoglobin A1c (HbA1c), and other conditions. METHODS Forty-one adults (17 men) with type 1 (N = 14) or type 2 (N = 27) diabetes mellitus, age 48.6 ± 13.5 years, diabetes duration 9 (0.1-36) years, BMI 29.4 ± 6.3 kg/m2 , and HbA1c 52 ± 12.7 mmol/mol completed the study. The 4-day study comprised two visits (Day l, Day 4) including 72 hr of continuous glucose monitoring (CGM) by iPro® 2 Professional CGM (Medtronic, MiniMed, Inc., Northridge, CA, USA). Retinal oximeter Oxymap T1 (Oxymap ehf., Reykjavik, Iceland) was used to assess SatO2 . RESULTS Wilcoxon signed-rank test showed no SatO2 difference between eyes and visits. Spearman's correlation analysis revealed a significant correlation between arterial SatO2 and PG variability in type 2 diabetes mellitus, a positive correlation of venous SatO2 with HbA1c and with finger pulse oximetry. However, no correlation of SatO2 with ABB, carboxyhaemoglobin, current PG, mean PG over the 72 hr, age, diabetes duration, BMI, lipoproteinaemia, body temperature, systolic and diastolic blood pressure, heart rate, central retinal thickness and retinal nerve fibre layer thickness was found. CONCLUSION This study confirmed the association of venous SatO2 with long-term but not with short-term diabetes control, ABB and other conditions. The increased SatO2 and questionable impact of PG variability on retinal SatO2 is a research challenge.
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Affiliation(s)
- Petr Mlčák
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Rudolf Chlup
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
- Department of Internal Medicine II – Gastroenterology and Hepatology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Pavla Kudlová
- Department of Health Sciences Faculty of Humanities Tomáš Baťa University Zlín Zlín Czech Republic
| | - Ondřej Krystyník
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Michal Král
- Department of Neurology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Veronika Kučerová
- Department of Clinical Biochemistry University Hospital Olomouc Olomouc Czech Republic
| | - Jaromíra Spurná
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Simona Titzová
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Petra Hübnerová
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Ondřej Vláčil
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Irena Šínová
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Marta Karhanová
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Jana Zapletalová
- Department of Medical Biophysics Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Martin Šín
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
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Bek T, Nielsen MS, Klug SE, Eriksen JE. Increasing metabolic variability increases the risk for vitrectomy in proliferative diabetic retinopathy. Int Ophthalmol 2021; 42:757-763. [PMID: 34625890 DOI: 10.1007/s10792-021-02041-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Proliferative diabetic retinopathy (PDR) can be treated by retinal photocoagulation, but in some cases, the treatment is initiated too late or is insufficient so that the disease advances to a stage requiring vitrectomy. There is a need to identify risk factors that can predict if patients with PDR will develop complications in need for vitrectomy. METHODS Survival analysis with death as competing risk was used to study systemic risk factors for PDR progression to a complication in need for vitrectomy in right eyes of all 1288 diabetic patients from the Aarhus area, Denmark, who had developed proliferative retinopathy in the right eye during the 25 years period from 1 July 1994 until 1 July 2019. RESULTS The overall cumulative incidence of reaching a vitrectomy end point in the right eye was 24.1% (n = 311). In 9.3% (n = 120) of the patients where vitrectomy had been performed together with the first photocoagulation, the age of onset of diabetes was significantly higher (p < 0.0001), the diabetes duration longer (p < 0.035) and BMI higher (p < 0.01) than in the patients who had been vitrectomized later than the first photocoagulation. The risk for vitrectomy was significantly increased by high variability of HbA1c before the development of PDR (p < 0.0001), but not by other parameters known to increase the risk for developing PDR. CONCLUSION Increasing variability of HbA1c before the development of PDR increases the risk for progression to a complication in need of vitrectomy. The need for vitrectomy is unaffected by other risk factors known to increase the risk for developing PDR.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, 8200, Aarhus N, Denmark.
| | - Mette Slot Nielsen
- Department of Ophthalmology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | - Sidsel Ehlers Klug
- Department of Ophthalmology, Aarhus University Hospital, 8200, Aarhus N, Denmark
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Abstract
Similar to other organs, the retina relies on tightly regulated perfusion and oxygenation. Previous studies have demonstrated that retinal blood flow is affected in a variety of eye and systemic diseases, including diabetic retinopathy, age-related macular degeneration, and glaucoma. Although measurement of peripheral oxygen saturation has become a standard clinical measurement through the development of pulse oximetry, developing a noninvasive technique to measure retinal oxygen saturation has proven challenging, and retinal oximetry technology currently remains inadequate for reliable clinical use. Here, we review current strategies and approaches, as well as several newer technologies in development, and discuss the future of retinal oximetry.
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Affiliation(s)
- Anupam K Garg
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.,School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Darren Knight
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Leonardo Lando
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Daniel L Chao
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.,School of Medicine, University of California San Diego, La Jolla, CA, USA.,Janssen Research and Development, Raritan, NJ, USA
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10
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Stodtmeister R, Mielke V, Sandner D. The Oxygen Saturation in the Retinal Vessels of Patients with Diabetes Mellitus - The Search for Determinants. Klin Monbl Augenheilkd 2021; 239:1016-1024. [PMID: 34000750 DOI: 10.1055/a-1384-0737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Oxygen saturation in retinal vessels can be non-invasively measured by a new method. It is known that oxygen extraction is lowered in diabetic retinopathy. In the cross-sectional study presented here, it has been investigated whether diabetes-specific changes and typical accompanying diseases could influence the measurements in oximetry. METHODS During a time span of seven months, 237 diabetics were included who came to our clinic for an intravitreal injection, who met the inclusion criteria, who showed no exclusion criteria and gave written consent. 203 eyes of 203 patients were evaluated. The oxygen saturation (SO2) was measured in digitally stored fundus images taken with a fundus camera (Zeiss 450 FF). In its illumination beam, a filter was inserted with two transmission maxima at 584 nm and 610 nm (bandwidth 10 nm). With the program "Oximetry" (Imedos Systems, Jena, Germany), the venous and the arterial SO2 were measured. The values were stored in a spreadsheet. Diabetes related data, clinical parameters and accompanying diseases were documented in the predefined scheme. RESULTS In the whole patient sample, the venous oxygen saturation (vSO2) was 69 ± 12%, the arterial saturation (aSO2) 99 ± 5% and the arteriovenous difference 31 ± 9%. A statistically significant association could not be found between the measurement values of oximetry and age, duration of diabetes and HbA1c (Kruskal-Wallis ANOVA: p > 0.05). The differences in oximetry values between units of analysis (UOA) e.g. hypertension and non units of analysis (NOA) were analysed. Descriptive testing showed significant differences in vSO2% in the following units of analysis: allergies n = 47: UOA vs. NUOA: 64 vs. 69 (t test: p < 0.02); sartan therapy n = 46: UOA vs. NUOA: 64 vs. 70 (p = 0.003); state after intravitreal injections n = 144: 68 vs. 71 (p = 0.02). Oxygen extraction from the retinal capillaries was improved in patients who had injections with VEGF inhibitors. An improvement in oxygen extraction is also seen in patients with allergies and hypertension in comparison to those without these units of analysis. CONCLUSION The clinically observed improvement in the retinal state situation after intravitreal injections with VEGF inhibitors may be seen in association with the improved oxygen extraction. It seems reasonable to study whether a switch to sartans in the therapy of hypertension may improve retinal function.
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Affiliation(s)
- Richard Stodtmeister
- Augenklinik, Technische Universität Dresden, Deutschland.,Poliklinik, Augenspezialisten Saar, Völklingen, Deutschland
| | - Vivien Mielke
- Augenklinik, Technische Universität Dresden, Deutschland
| | - Dirk Sandner
- Augenklinik, Technische Universität Dresden, Deutschland
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Hardarson SH, Stefánsson E, Bek T. Retinal oxygen saturation changes progressively over time in diabetic retinopathy. PLoS One 2021; 16:e0251607. [PMID: 33979414 PMCID: PMC8115819 DOI: 10.1371/journal.pone.0251607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE According to cross-sectional studies, oxygen saturation is elevated in retinal vessels in diabetic patients. We evaluated how retinal oxygenation (metabolic marker), vessel diameters and retinopathy grade (structural markers) change over time in diabetic patients. DESIGN Prospective cohort study following screening in a hospital setting. METHODS Retinal oximetry images were acquired in 214 patients with the Oxymap T1 oximeter. Imaging was repeated after a median of 3.0 years (range 0.76-6.8 years). Oxygen saturation and vessel diameters were measured in the right eye. Semiquantitative grading of retinopathy according to international guidelines and red lesion count were performed on fundus photographs. RESULTS Retinopathy grade according to the international semiquantitative grading system was unchanged. Arteriolar saturation increased by 0.75±0.15 percentage points per year of follow-up (p<0.0001). Venular saturation increased by 1.74±0.26 percentage points per year (p<0.0001) and arteriovenous difference decreased by 0.99±0.20 percentage points per year (p<0.0001). Arteriolar diameters decreased by 2.7±8.5μm (p<0.0001) between visits and venular diameters decreased by 2.4±9.1μm (p = 0.0002). Median increase in red lesion count between visits was 2 lesions (range -128 to 212 lesions, p<0.0001). The change in red lesion count and change in diameters did not correlate with the length of follow-up (p>0.44). CONCLUSIONS Oxygen saturation in larger retinal vessels can increase and arteriovenous difference can decrease over time in diabetic patients without any observable changes in retinopathy grade. The results suggest that changes in retinal oxygen saturation may precede progression of diabetic retinopathy or that oxygen saturation is more sensitive to disease progression than retinopathy grade.
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Affiliation(s)
- Sveinn Hakon Hardarson
- Institute of Physiology, Department of Medicine, University of Iceland, Reykjavik, Iceland
- * E-mail:
| | - Einar Stefánsson
- Institute of Physiology, Department of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Ophthalmology, Landspitali University Hospital, Reykjavik, Iceland
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus N, Denmark
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Liu R, Jian W, Zhao Y, Lu X, Wu Y, Duan J. Retinal oxygen saturation and vessel diameter in patients with chronic kidney disease. Acta Ophthalmol 2021; 99:e352-e359. [PMID: 32529722 DOI: 10.1111/aos.14398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate changes in retinal oximetry and the diameter of retinal vasculature in patients with chronic kidney disease (CKD) and relationships between retinal vasculature and the estimated glomerular filtration rate (eGFR), provide a scientific basis for the early detection and diagnosis of CKD. METHODS Eighty-three patients with CKD and 103 healthy individuals were included after providing informed consent. All participants were examined using a noninvasive technology (Oxymap Inc., Reykjavik, Iceland) for measuring the arterial (SaO2 ) and venous (SvO2 ) oxygen saturation and the arteriovenous difference in oxygen saturation (Sa-vO2 ). The corresponding retinal vessel diameters of these arterioles (D-A) and venules (D-V) were measured. The eGFR of patients with CKD was calculated from the serum creatinine concentration. RESULTS In general, patients with CKD had higher mean SaO2 values than healthy individuals (100.15 ± 4.68% versus 97.14 ± 4.22%; p < 0.001, mean ± SD). The mean SaO2 in the superior temporal, superior nasal and inferior nasal quadrants significantly increased. There was no significant difference measured in the SvO2 when patients with CKD (63.66 ± 5.29%) and healthy individuals (62.70 ± 5.27%) were compared. The mean Sa-vO2 of the CKD group (36.49 ± 4.98%) was increased compared with normal subjects (34.44 ± 4.76%) (p = 0.005). The retinal arteriole diameter was narrower in patients with CKD than in normal individuals (117.53 ± 14.88 μm versus 126.87 ± 14.98 μm; p < 0.001, mean ± SD), and the arteriovenous ratio was smaller than in normal individuals (0.71 ± 0.09 versus 0.77 ± 0.09; p < 0.001, mean ± SD). Pearson's two-tailed correlation showed a significant correlation between the SaO2 and eGFR (R = -0.363, p = 0.001), and narrower retinal arterial calibre was significantly associated with a lower eGFR (R = 0.415, p < 0.001). CONCLUSION Based on our results, there were alterations in retinal oxygen saturation and vascular diameter in patients with CKD. Further studies are needed to determine whether such changes play a role in the development of CKD.
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Affiliation(s)
- Ruibao Liu
- Eye College of Chengdu University of TCM Chengdu Sichuan China
| | - Wenyuan Jian
- Eye College of Chengdu University of TCM Chengdu Sichuan China
| | - Ying Zhao
- Eye College of Chengdu University of TCM Chengdu Sichuan China
| | - Xuejing Lu
- Eye College of Chengdu University of TCM Chengdu Sichuan China
- Ineye Hospital of Chengdu University of TCM Chengdu Sichuan China
| | - Yanxia Wu
- Eye College of Chengdu University of TCM Chengdu Sichuan China
| | - Junguo Duan
- Eye College of Chengdu University of TCM Chengdu Sichuan China
- Ineye Hospital of Chengdu University of TCM Chengdu Sichuan China
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Bek T, Jeppesen SK. Reduced Oxygen Extraction in the Retinal Periphery When the Arterial Blood Pressure Is Increased by Isometric Exercise in Normal Persons. Invest Ophthalmol Vis Sci 2021; 62:11. [PMID: 33683296 PMCID: PMC7960864 DOI: 10.1167/iovs.62.3.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose Recent evidence suggests that the smaller retinal vessels are significantly involved in the regulation of retinal blood flow and that this regulation may differ among the macular area and the retinal periphery. An alternative to studying blood flow regulation in smaller retinal vessels that are difficult to resolve is to assess the metabolic consequences of changes in the microcirculation using oximetry. Methods In 20 normal persons aged (mean ± SD, range) 30.1 ± 3.8 (24–37) years, the oxygen saturation and diameter of retinal arterioles and venules to the macular area and the retinal periphery were studied before and during an increase in the arterial blood pressure induced by isometric exercise. Results The isometric exercise increased the mean arterial blood pressure by (mean ± SEM) 10.0 ± 1.1 mm Hg but induced no significant changes in the diameter of the arterioles (P = 0.83). The isometric exercise had no significant effect on the oxygen saturation in the arterioles supplying the macular area and the retinal periphery (P > 0.42 for both comparisons). However, there was a significant increase in the oxygen saturation in venules draining the retinal periphery to reduce the oxygen extraction from (mean ± SEM) 36.0% ± 2.3% to 30.6% ± 2.1% (P = 0.002) but no significant change in the preexisting low oxygen extraction in the macular area that changed from (mean ± SEM) 18.2% ± 3.0% to 16.2% ± 1.9% (P = 0.37). Conclusions Minor changes in the arterial blood pressure can induce changes in retinal rheology with significant regional variation. The finding may help explain regional variations in manifestations of retinal vascular disease such as hyperpermeability in the macular area and capillary occlusion in the retinal periphery.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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C.B.B. Veiby N, Simeunovic A, Heier M, Brunborg C, Saddique N, Moe MC, Dahl‐Jørgensen K, Margeirsdottir HD, Petrovski G. Venular oxygen saturation is increased in young patients with type 1 diabetes and mild nonproliferative diabetic retinopathy. Acta Ophthalmol 2020; 98:800-807. [PMID: 32410388 DOI: 10.1111/aos.14462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/08/2020] [Accepted: 04/18/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To clarify how early in the development of diabetic retinopathy (DR) can oxygen (O2 ) saturation changes be detected. METHODS Retinal oximetry was performed in a cross-sectional study, involving 14- to 30-year-old individuals: 185 with type 1 diabetes (T1D) and 94 controls. The subjects were divided into four groups according to the grade of DR. One-way ANOVA and post hoc tests were used to test for differences in the mean O2 saturations between the groups. RESULTS Fifty-eight (31 %) of the T1D patients had nonproliferative DR. There was no significant difference in O2 saturations between controls and T1D patients with no DR. Arteriolar and venular O2 saturations in T1D patients were significantly higher in moderate/severe DR than in no DR (p = 0.009 and p > 0.001), while venular O2 saturation was significantly higher in mild DR than in no DR (p = 0.013). CONCLUSION Increase in venular O2 saturation could not be detected before mild retinopathy had developed, and the retinal O2 saturation increase was measurable on the venular side first. Our results suggest that the increase in O2 saturation is likely a consequence of DR.
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Affiliation(s)
- Nina C.B.B. Veiby
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Aida Simeunovic
- Department of Paediatrics and adolescent Medicine Akershus University Hospital Lorenskog Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Martin Heier
- Oslo Diabetes Research Centre Oslo Norway
- Department of Paediatrics Oslo University Hospital Oslo Norway
| | - Cathrine Brunborg
- Oslo Centre of Biostatistics and Epidemiology Oslo University Hospital Oslo Norway
| | - Naila Saddique
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Morten C. Moe
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
| | - Knut Dahl‐Jørgensen
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
- Department of Paediatrics Oslo University Hospital Oslo Norway
| | - Hanna D. Margeirsdottir
- Oslo Diabetes Research Centre Oslo Norway
- Department of Paediatrics Oslo University Hospital Oslo Norway
| | - Goran Petrovski
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
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Szulc U, Dąbrowska E, Pieczyński J, Białkowski P, Narkiewicz K, Schmieder RE, Harazny J. How to measure retinal microperfusion in patients with arterial hypertension. Blood Press 2020; 30:4-19. [PMID: 32969283 DOI: 10.1080/08037051.2020.1823816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Assessment and monitoring of changes in microcirculatory perfusion, perfusion dynamic, vessel structure and oxygenation is crucial in management of arterial hypertension. Constant search for non-invasive methods has led the clinical focus towards the vasculature of the retina, which offers a large opportunity to detect the early phase of the functional and structural changes in the arterial hypertension and can reflect changes in brain vasculature. We review all the available methods of retinal microcirculation measurements including angiography, oximetry, retinal vasculature assessment software, Optical Coherence Tomography Angiography, Adaptive Optics and Scanning Laser Doppler Flowmetry and their application in clinical research. MATERIALS AND METHODS To further analyse the applicability of described methods in hypertension research we performed a systematic search of the PubMed electronic database (April 2020). In our analysis, we included 111 articles in which at least one of described methods was used for assessment of microcirculation of the retina in hypertensive individuals. RESULTS Up to this point, the methods most commonly published in studies of retinal microcirculation in arterial hypertension were Scanning Laser Doppler Flowmetry followed shortly by Optical Coherence Tomography Angiography and retinal vasculature assessment software. CONCLUSIONS While none of described methods enables the simultaneous measurement of all microcirculatory parameters, certain techniques are widely used in arterial hypertension research, while others gain popularity in screening.
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Affiliation(s)
- Urszula Szulc
- Department of Human Physiology and Pathophysiology, University Warmia and Mazury, Olsztyn, Poland
| | - Edyta Dąbrowska
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.,First Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Janusz Pieczyński
- Department of Ophthalmology, University Warmia and Mazury, Olsztyn, Poland
| | - Paweł Białkowski
- Department of Ophthalmology, Provincial Specialist Hospital, Olsztyn, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Roland E Schmieder
- Clinical Research Center, Department of Nephrology and Hypertensiology, University Erlangen-Nuremberg, Erlangen, Germany
| | - Joanna Harazny
- Department of Human Physiology and Pathophysiology, University Warmia and Mazury, Olsztyn, Poland.,Clinical Research Center, Department of Nephrology and Hypertensiology, University Erlangen-Nuremberg, Erlangen, Germany
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Bek T. Incidence and Risk for Developing Proliferative Diabetic Retinopathy after Photocoagulation for Diabetic Maculopathy. Curr Eye Res 2020; 45:986-991. [DOI: 10.1080/02713683.2020.1712729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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17
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Takasago Y, Fujita T, Nakano Y, Osaka R, Miyake M, Muraoka Y, Tsujikawa A. Ranibizumab treatment improves diabetic macular oedema without influencing retinal oximetry parameters. Acta Ophthalmol 2019; 97:e1048-e1053. [PMID: 31127694 DOI: 10.1111/aos.14145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/28/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To evaluate the effect of ranibizumab on retinal oximetry in eyes with diabetic macular oedema (DME). METHODS In this prospective interventional study, 30 eyes (30 patients) with DME were treated with three-monthly intravitreal ranibizumab injections, followed by pro re nata administration for 12 months. Retinal oximetry was performed using an Oxymap T1. RESULTS The mean number of injections was 6.6 ± 2.5. No adverse event was observed throughout the study period. Ranibizumab treatments for 12 months improved the macular oedema (p = 0.002) and achieved a recovery of visual acuity (VA; p = 0.011). However, oxygen saturation levels in the major retinal blood vessels, either the arteries or the veins, remained unchanged during the observational period. Arterial oxygen saturation was 100.3 ± 9.4% before treatment and 100.9 ± 10.7% (p = 0.698) at 6 months. Venous oxygen saturation was 56.4 ± 8.9% before treatment and 55.6 ± 8.6% (p = 0.529) at 6 months. In addition, there were no significant changes in diameters of the major retinal arteries and veins. Greater improvement of VA at 12 months was correlated with a smaller number of ranibizumab injections (r = 0.459, p = 0.011). The number of ranibizumab injections during these 12 months correlated with an increased baseline central retinal thickness (r = 0.385, p = 0.035). CONCLUSION Ranibizumab treatments for DME improved the macular oedema and achieved VA recovery, but no changes were noted in the retinal oxygen saturation.
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Affiliation(s)
- Yukari Takasago
- Department of Ophthalmology Kagawa University Faculty of Medicine Kagawa Japan
| | - Tomoyoshi Fujita
- Department of Ophthalmology Kagawa University Faculty of Medicine Kagawa Japan
| | - Yuki Nakano
- Department of Ophthalmology Kagawa University Faculty of Medicine Kagawa Japan
| | - Rie Osaka
- Department of Ophthalmology Kagawa University Faculty of Medicine Kagawa Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuki Muraoka
- Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine Kyoto Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences Kyoto University Graduate School of Medicine Kyoto Japan
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PRESENCE OF PERIPHERAL LESIONS AND CORRELATION TO MACULAR PERFUSION, OXYGENATION AND NEURODEGENERATION IN EARLY TYPE II DIABETIC RETINAL DISEASE. Retina 2019; 40:1964-1971. [DOI: 10.1097/iae.0000000000002704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Damodaran M, Amelink A, Feroldi F, Lochocki B, Davidoiu V, de Boer JF. In vivo subdiffuse scanning laser oximetry of the human retina. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-14. [PMID: 31571433 PMCID: PMC6997660 DOI: 10.1117/1.jbo.24.9.096009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Scanning laser ophthalmoscopes (SLOs) have the potential to perform high speed, high contrast, functional imaging of the human retina for diagnosis and follow-up of retinal diseases. Commercial SLOs typically use a monochromatic laser source or a superluminescent diode for imaging. Multispectral SLOs using an array of laser sources for spectral imaging have been demonstrated in research settings, with applications mainly aiming at retinal oxygenation measurements. Previous SLO-based oximetry techniques are predominantly based on wavelengths that depend on laser source availability. We describe an SLO system based on a supercontinuum (SC) source and a double-clad fiber using the single-mode core for illumination and the larger inner cladding for quasi-confocal detection to increase throughput and signal-to-noise ratio. A balanced detection scheme was implemented to suppress the relative intensity noise of the SC source. The SLO produced dual wavelength, high-quality images at 10 frames / s with a maximum 20 deg imaging field-of-view with any desired combination of wavelengths in the visible spectrum. We demonstrate SLO-based dual-wavelength oximetry in vessels down to 50 μm in diameter. Reproducibility was demonstrated by performing three different imaging sessions of the same volunteer, 8 min apart. Finally, by performing a wavelength sweep between 485 and 608 nm, we determined, for our SLO geometry, an approximately linear relationship between the effective path length of photons through the blood vessels and the vessel diameter.
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Affiliation(s)
- Mathi Damodaran
- Vrije Universiteit Amsterdam, LaserLaB, Department of Physics and Astronomy, Amsterdam, The Netherlands
| | - Arjen Amelink
- Netherlands Organization for Applied Scientific Research TNO, Department of Optics, Delft, The Netherlands
| | - Fabio Feroldi
- Vrije Universiteit Amsterdam, LaserLaB, Department of Physics and Astronomy, Amsterdam, The Netherlands
| | - Benjamin Lochocki
- Vrije Universiteit Amsterdam, LaserLaB, Department of Physics and Astronomy, Amsterdam, The Netherlands
| | - Valentina Davidoiu
- Vrije Universiteit Amsterdam, LaserLaB, Department of Physics and Astronomy, Amsterdam, The Netherlands
| | - Johannes F. de Boer
- Vrije Universiteit Amsterdam, LaserLaB, Department of Physics and Astronomy, Amsterdam, The Netherlands
- Amsterdam UMC, Ophthalmology Department, Amsterdam, The Netherlands
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