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Sideri AM, Kanakis M, Katsimpris A, Karamaounas A, Brouzas D, Petrou P, Papakonstaninou E, Droutsas K, Kandarakis S, Giannopoulos G, Georgalas I. Correlation Between Coronary and Retinal Microangiopathy in Patients With STEMI. Transl Vis Sci Technol 2023; 12:8. [PMID: 37145590 PMCID: PMC10168007 DOI: 10.1167/tvst.12.5.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Purpose To investigate the morphological and functional correlation between microvascular retinal changes in optical coherence tomography angiography (OCTA) and the microvascular coronary circulation in patients with ST elevation myocardial infarction (STEMI) coronary heart disease (CHD). Methods A total of 330 eyes from 165 participants (88 cases and 77 controls) were enrolled and imaged. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vascular density was measured in the central (1 mm) and perifoveal (1-3 mm) areas and in the superficial foveal avascular zone (FAZ) and choriocapillaris (3 mm). These parameters were then correlated to the left ventricular ejection fraction (LVEF), and the number of affected coronary arteries. Results Decreased vessel densities in the SCP and DCP and choriocapillaris were positively correlated to the LVEF values (P = 0.006, P = 0.026, and P = 0.002, respectively). No statistically significant correlation between the SCP and DCP central area or FAZ area was found. Regarding the number of affected vessels, significant negative correlations were revealed for the SCP and DCP central vessel densities (P < 0.001 and P < 0.001, respectively) and the SCP perifoveal vascular density (P = 0.009). Conclusions OCTA vascular indices are significantly correlated with morphological and functional parameters in patients with STEMI CHD. SCP vascular density especially seems to be a promising biomarker for the extent of both macrovascular damage (number of affected coronary arteries) and microvascular damage, as mirrored in the decreased LVEF at admission. Translational Relevance OCTA vascular indices offer a valuable insight into the microvascular status of coronary circulation.
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Affiliation(s)
- Anna-Maria Sideri
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Menelaos Kanakis
- School of Medicine, University of Patras, University Eye Clinic, Rion University Hospital, Patras, Greece
| | - Andreas Katsimpris
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Aristotelis Karamaounas
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Dimitrios Brouzas
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Petros Petrou
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Evangelia Papakonstaninou
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Konstantinos Droutsas
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Stylianos Kandarakis
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
| | - Georgios Giannopoulos
- 3rd Department of Cardiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ilias Georgalas
- School of Medicine, National and Kapodistrian University of Athens, 1st University Eye Clinic, G. Gennimatas General Hospital of Athens, Athens, Greece
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Bozkurt S, Ayten UE. ln silico simulation of the interaction among autoregulatory mechanisms regulating cerebral blood flow rate in the healthy and systolic heart failure conditions during exercise. Med Biol Eng Comput 2022; 60:1863-1879. [DOI: 10.1007/s11517-022-02585-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022]
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Cardiovascular Risk Stratification in Diabetic Retinopathy via Atherosclerotic Pathway in COVID-19/non-COVID-19 Frameworks using Artificial Intelligence Paradigm: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12051234. [PMID: 35626389 PMCID: PMC9140106 DOI: 10.3390/diagnostics12051234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
Diabetes is one of the main causes of the rising cases of blindness in adults. This microvascular complication of diabetes is termed diabetic retinopathy (DR) and is associated with an expanding risk of cardiovascular events in diabetes patients. DR, in its various forms, is seen to be a powerful indicator of atherosclerosis. Further, the macrovascular complication of diabetes leads to coronary artery disease (CAD). Thus, the timely identification of cardiovascular disease (CVD) complications in DR patients is of utmost importance. Since CAD risk assessment is expensive for low-income countries, it is important to look for surrogate biomarkers for risk stratification of CVD in DR patients. Due to the common genetic makeup between the coronary and carotid arteries, low-cost, high-resolution imaging such as carotid B-mode ultrasound (US) can be used for arterial tissue characterization and risk stratification in DR patients. The advent of artificial intelligence (AI) techniques has facilitated the handling of large cohorts in a big data framework to identify atherosclerotic plaque features in arterial ultrasound. This enables timely CVD risk assessment and risk stratification of patients with DR. Thus, this review focuses on understanding the pathophysiology of DR, retinal and CAD imaging, the role of surrogate markers for CVD, and finally, the CVD risk stratification of DR patients. The review shows a step-by-step cyclic activity of how diabetes and atherosclerotic disease cause DR, leading to the worsening of CVD. We propose a solution to how AI can help in the identification of CVD risk. Lastly, we analyze the role of DR/CVD in the COVID-19 framework.
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Lau KG, Baloi M, Dumitrascu-Biris D, Nicolaides KH, Kametas NA. Changes in ophthalmic artery Doppler during acute blood-pressure control in hypertensive pregnant women. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 59:185-191. [PMID: 34358385 DOI: 10.1002/uog.23755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine the changes in ophthalmic artery Doppler indices and their association with changes in mean arterial blood pressure (MAP) and systolic (SBP) and diastolic (DBP) blood pressure, following acute antihypertensive treatment in women with hypertensive disorders of pregnancy presenting with high blood pressure. METHODS This was a prospective cohort study of 31 pregnant women presenting at 30 + 0 to 39 + 6 weeks' gestation for management of their hypertension. Paired maternal blood-pressure and ophthalmic-artery-Doppler measurements were performed prior to and at 30 min and 60 min after starting antihypertensive medication. In patients who did not achieve blood-pressure control (i.e. when blood pressure was < 140/90 mmHg) by 60 min, paired readings were continued up to 120 min. If blood-pressure control was still not achieved at that point, patients were admitted to hospital. Univariate linear regression was performed to determine the association of ophthalmic artery peak systolic velocity (PSV) ratio with SBP, DBP and MAP before treatment and after blood-pressure control. The longitudinal changes in MAP, SBP, DBP and PSV ratio from pretreatment to 30 min and 60 min after commencement of antihypertensives were examined by repeated measure, multilevel, linear mixed-effects analysis. RESULTS Antihypertensive treatment was associated with a decrease in SBP, DBP, MAP and PSV ratio. At 60 min following antihypertensive treatment, the decrease in SBP, DBP, MAP and PSV ratio was 12.1 mmHg (95% CI, 9.0-15.1 mmHg; P < 0.0001), 9.1 mmHg (95% CI, 6.5-11.5 mmHg; P < 0.0001), 10.0 mmHg (95% CI, 7.6-12.4 mmHg; P < 0.0001) and 0.07 (95% CI, 0.03-0.11 mmHg; P < 0.001), respectively. From the total cohort, 20 (64.5%) women had achieved blood-pressure control at 60 min and another seven (22.6%) by 120 min from commencement of antihypertensive treatment. Four (12.9%) women did not achieve blood-pressure control during this period and were admitted to hospital. The relationship between PSV ratio and SBP, DBP and MAP was assessed before treatment (n = 31) and at the point of blood-pressure control in women in whom this was achieved by 120 min (n = 27). Prior to treatment, there was a significant association between PSV ratio and MAP (P < 0.0001, R2 = 0.39). This was primarily due to the association of PSV ratio with DBP (P < 0.0001, R2 = 0.39) and less so due to its association with SBP (P = 0.02, R2 = 0.16). At the point of achieving blood-pressure control, there was no significant association between PSV ratio and MAP (P = 0.7), DBP (P = 0.5) or SBP (P = 0.7). CONCLUSIONS Acute blood-pressure control in pregnancy is associated with a concomitant reduction in blood pressure and ophthalmic artery PSV ratio. In hypertensive pregnant women, there is a significant association of PSV ratio with MAP, SBP and DBP, which disappears after blood pressure is reduced to < 140/90 mmHg following antihypertensive treatment. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- K G Lau
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Antenatal Hypertension Clinic, King's College Hospital, London, UK
| | - M Baloi
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Antenatal Hypertension Clinic, King's College Hospital, London, UK
| | - D Dumitrascu-Biris
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Antenatal Hypertension Clinic, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - N A Kametas
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Antenatal Hypertension Clinic, King's College Hospital, London, UK
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Zhong P, Hu Y, Jiang L, Peng Q, Huang M, Li C, Kuang Y, Tan N, Yu H, Yang X. Retinal Microvasculature Changes in Patients With Coronary Total Occlusion on Optical Coherence Tomography Angiography. Front Med (Lausanne) 2022; 8:708491. [PMID: 34977052 PMCID: PMC8716542 DOI: 10.3389/fmed.2021.708491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/29/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Retinal microvasculature has been associated with coronary artery disease (CAD), but the exact contributory role in coronary total occlusion (CTO) is unclear. We aimed to investigate whether retinal vasculature is associated with CTO and could provide incremental value in the assessment of CTO. Methods: A total of 218 CAD patients including 102 CTO and 116 non-CTO were enrolled. Retinal vasculature was measured by optical coherence tomography angiography (OCTA) for all patients. Receiver operating characteristic (ROC) curve was used to assess the performance of retinal vasculature in differentiating CTO from non-CTO patients. Results: In non-CTO CAD patients, vessel density (VD) of mean superficial capillary plexus (SCP) and parafovea SCP were 49.85 and 52.56%, respectively; in CTO patients, VD of mean SCP and parafovea SCP were 47.77, and 49.58%, respectively. After multiple adjustment, VD in the SCP was significantly lower in CTO patients compared to non-CTO patients. VD of superior hemi in the parafovea SCP combined with the clinical variates showed the best ability to predict CTO from CAD with an area under the curve (AUC) of 0.812 (specificity of 89.0% and sensitivity of 65.9%). Conclusions: In CTO patients, retinal VD was significantly decreased, and microvascular damage might specifically target to arterioles than capillaries. Retinal vasculature could thus be a surrogate for detecting the microvascular damage and assist in the assessment of CTO patients. OCTA examination could be suggested to monitor the process of coronary arteries lesions.
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Affiliation(s)
- Pingting Zhong
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Aier School of Ophthalmology, Central South University, Changsha, China.,Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Lei Jiang
- Guangdong Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qingsheng Peng
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Manqing Huang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Cong Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Yu Kuang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ning Tan
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Wu LT, Wang JL, Wang YL. Ophthalmic Artery Morphological and Hemodynamic Features in Acute Coronary Syndrome. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 34757418 PMCID: PMC8590173 DOI: 10.1167/iovs.62.14.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine the morphological and hemodynamic changes of the ophthalmic artery (OA) in patients with acute coronary syndrome (ACS). Methods This cross-sectional observational study included 31 patients with ACS and 10 healthy controls (HCs). The ACS subgroups were ST-segment elevation myocardial infarction (STEMI; n = 10), non-STEMI (n = 10), and unstable angina (n = 11). OA three-dimensional (3D) models were reconstructed based on computed tomographic angiography, and morphological aspects of the OA were measured quantitatively. Moreover, numerical simulation by computational fluid dynamics was used to obtain hemodynamic information of the OA. Results The study reconstructed 41 OA models. Hemodynamic simulation revealed a significant decrease in OA blood velocity in patients with ACS compared with the HCs (median velocity, 0.046 vs. 0.147 m/s; P < 0.001). No differences in the morphological data for the OA were observed. Also, no differences in the mass flow ratio of OA to the ipsilateral internal carotid artery was found. Similar differences were observed between the ACS subgroups and HCs. OA blood velocity was negatively correlated with body mass index, abdominal circumference, left ventricular ejection fraction, and triacylglycerol and was positively correlated with early to late transmitral flow velocity, N-terminal pro-brain natriuretic peptide, serum creatinine, and potassium. Conclusions The initial OA blood velocity was slower in patients with ACS and was associated with ACS-related clinical parameters. To our knowledge, this is the first study to analyze OA characteristics in ACS using 3D model reconstruction and hemodynamic simulation, providing new perspectives on the relationship between ischemic heart disease and ocular manifestations.
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Affiliation(s)
- Lan-Ting Wu
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jia-Lin Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yan-Ling Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy. J Clin Med 2021; 10:jcm10122659. [PMID: 34208770 PMCID: PMC8235508 DOI: 10.3390/jcm10122659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 01/23/2023] Open
Abstract
(1) Introduction: The aim of this study is to assess retinal vessel density (VD) in the superficial capillary plexus layer (SP) and deep capillary plexus layer (DP) in children with chronic heart failure (CHF) in the course of dilated cardiomyopathy (DCM) using optical coherence tomography angiography (OCTA). (2) Methods: Thirty children with CHF due to DCM lasting more than six months, with an enlarged left ventricle and impaired left ventricular systolic function (left ventricular ejection fraction (LVEF) ≤ 55%), were enrolled to have both their eyes assessed for this study. Mean age of the children was 9.9 ± 3.57 years. The control group consisted of an additional 30 children without CHF (mean age 11.27 ± 3.33 years) matched for age and gender against the study group. All participants underwent transthoracic echocardiography to measure LVEF using Simpson method. Blood serum was tested for N-terminal-pro-brain natriuretic peptide (NT-proBNP) marker value. All children underwent OCTA with evaluation of the foveal avascular zone (FAZ), whole superficial vessel density (wsVD), foveal superficial vessel density (fsVD), parafoveal superficial vessel density (psVD), whole deep vessel density (wdVD), foveal deep vessel density (fdVD), parafoveal deep vessel density (pdVD), whole thickness (WT), foveal thickness (FT), and parafoveal thickness (PFT). (3) Results: Retinal VD in SP was significantly lower in children with CHF as compared to the controls. The following SP parameters in the study group were statistically significantly lower than these same measurements for the control group. Details, with study group findings quantified first, include wsVD (46.2% vs. 49.83%, p < 0.05), fsVD (18.07% vs. 24.15%, p < 0.05), and psVD (49.24% vs. 52.51%, p < 0.05). The WT (311.03 micrometers (μm) vs. 323.55 μm, p < 0.05), FT (244.57 μm vs. 256.98 μm, p < 0.05), and PFT (320.63 μm vs. 332.02 μm, p < 0.05). No significant differences in DP retinal VD were found between the two groups. No statistically significant differences in the FAZ were found. The fsVD and FT were correlated with biometry and the age of the study participants. There was a correlation between FAZ and FT (p < 0.001). There were no correlations between retinal VD in both plexuses and refractive error, sex, NT-proBNP, and LVEF. (4) Conclusions: In children with CHF in the course of DCM as compared to the control group, significantly decreased retinal VD in SP was observed. The results of our study indicate that measurements of the OCTA may be a useful diagnostic method in children with chronic heart failure, but it is necessary to conduct further studies in larger groups of participants and long-term observation of these patients.
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Investigating Ganglion Cell Complex Thickness in Children with Chronic Heart Failure due to Dilated Cardiomyopathy. J Clin Med 2020; 9:jcm9092882. [PMID: 32906583 PMCID: PMC7563704 DOI: 10.3390/jcm9092882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/23/2020] [Accepted: 09/01/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To assess ganglion cell complex (GCC) thickness in children with chronic heart failure (CHF) due to dilated cardiomyopathy (DCM) using optical coherence tomography (OCT). METHODS Sixty eyes of 30 patients with chronic heart failure (CHF) due to dilated cardiomyopathy (DCM) and 60 eyes of 30 age- and sex-matched healthy volunteers (control group) were enrolled. The mean age of the patients and controls was 9.9 ± 3.57 (range 5-17) years and 10.08 ± 3.41 (range 4-16) years, respectively. All patients underwent a complete ophthalmic assessment and OCT imaging using RTVue XR Avanti (Optovue). The following OCT-based parameters were analysed: average ganglion cell complex thickness (avgGCC), superior ganglion cell complex thickness (supGCC), inferior ganglion cell complex thickness (infGCC), global loss of volume (GLV) and focal loss of volume (FLV). RESULTS There were no significant differences in avgGCC (98.13 μm vs. 99.96 μm, p = 0.21), supGCC (97.17 μm vs. 99.29 μm, p = 0.13), infGCC (99.03 μm vs. 100.71 μm, p = 0.25), FVL (0.49% vs. 0.4%, p = 0.25) and GVL (2.1% vs. 1.3%, p = 0.09) between patients with chronic heart failure due to dilated cardiomyopathy and healthy children. There was no correlation between avgGCC, supGCC, infGCC, FLV, GLV and ocular biometry, refractive errors or age. There was no correlation between avgGCC, supGCC, infGCC, FLV, GLV and NT-proBNP or LVEF. There were no significant differences in the studied parameters between the sexes. There were no significant differences in the studied parameters between the left and right eye. CONCLUSION Our study seems to be the first to analyse ganglion cell complex in paediatric patients with dilated cardiomyopathy. We have demonstrated no changes in the ganglion cell complex thickness parameters in children with chronic heart failure due dilated cardiomyopathy, as compared to their healthy peers.
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Arnould L, Seydou A, Gabrielle PH, Guenancia C, Tzourio C, Bourredjem A, El Alami Y, Daien V, Binquet C, Bron AM, Creuzot-Garcher C. Subfoveal Choroidal Thickness, Cardiovascular History, and Risk Factors in the Elderly: The Montrachet Study. ACTA ACUST UNITED AC 2019; 60:2431-2437. [DOI: 10.1167/iovs.18-26488] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Louis Arnould
- Department of Ophthalmology, University Hospital, Dijon, France
- INSERM, CIC1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, Dijon, France
- Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
| | - Alassane Seydou
- INSERM, CIC1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, Dijon, France
- Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
| | - Pierre-Henry Gabrielle
- Department of Ophthalmology, University Hospital, Dijon, France
- Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
| | - Charles Guenancia
- Department of Cardiology, Dijon University Hospital, Dijon, France
- PEC 2, University Hospital, Dijon, France
| | | | - Abderrahmane Bourredjem
- INSERM, CIC1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, Dijon, France
| | | | - Vincent Daien
- Department of Ophthalmology, University Hospital, Montpellier, France
| | - Christine Binquet
- INSERM, CIC1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, Dijon, France
| | - Alain Marie Bron
- Department of Ophthalmology, University Hospital, Dijon, France
- Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, University Hospital, Dijon, France
- Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, Dijon, France
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10
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Arnould L, Guenancia C, Azemar A, Alan G, Pitois S, Bichat F, Zeller M, Gabrielle PH, Bron AM, Creuzot-Garcher C, Cottin Y. The EYE-MI Pilot Study: A Prospective Acute Coronary Syndrome Cohort Evaluated With Retinal Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci 2019; 59:4299-4306. [PMID: 30372758 DOI: 10.1167/iovs.18-24090] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the association between retinal microvasculature (vascular density) on optical coherence tomography-angiography (OCT-A) and the cardiovascular profile of patients hospitalized for acute coronary syndrome (ACS). Methods EYE-Myocardial Infarction (EYE-MI) study is a prospective cross-sectional study in the Cardiology Intensive Care Unit of Dijon University Hospital. Retinal OCT-A was performed for each patient within 2 days after admission. Superficial retinal capillary plexus (SCP) vascular density was measured. The population was divided into tertiles according to OCT-A data. Results Overall, 237 cases were retained for analysis. Patients in the tertile with the lowest retinal vascular density (RVD) were older, and more frequently had systemic hypertension and diabetes. Moreover, American Heart Association (AHA) risk and Global Registry of Acute Coronary Events (GRACE) scores were higher and left ventricular ejection fraction (LVEF) was lower in these patients. In multivariate analysis, the AHA risk score (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.04-1.09; P < 0.001) and LVEF (OR, 0.95; 95% CI, 0.93-0.98; P = 0.001) were significantly associated with the lowest tertile of RVD. The association between RVD and a high-risk cardiovascular profile was confirmed by a moderate correlation with the GRACE scores (Spearman r = -0.33, P < 0.001). Conclusions SCP density measured on OCT-A was associated with the cardiovascular risk profile and with impaired LVEF in patients with a high-risk cardiovascular status. In the future, quantitative retinal microvascular data could be considered a good surrogate of the cardiovascular risk profile and could improve cardiovascular risk assessments.
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Affiliation(s)
- Louis Arnould
- Ophthalmology Department, University Hospital, Dijon, France.,INSERM, CIC1432, Clinical Epidemiology Unit, Dijon University Hospital, Dijon, France.,Centre des Science du Gout et de l'Alimentation CNRS, INRA, University Bourgogne Franche-Comte, Dijon, France
| | - Charles Guenancia
- Cardiology Department, University Hospital, Dijon, France.,PEC 2, University Bourgogne Franche-Comte, Dijon, France
| | - Arthur Azemar
- Cardiology Department, University Hospital, Dijon, France
| | - Guillaume Alan
- Cardiology Department, University Hospital, Dijon, France
| | | | | | | | - Pierre-Henry Gabrielle
- Ophthalmology Department, University Hospital, Dijon, France.,Centre des Science du Gout et de l'Alimentation CNRS, INRA, University Bourgogne Franche-Comte, Dijon, France
| | - Alain M Bron
- Ophthalmology Department, University Hospital, Dijon, France.,Centre des Science du Gout et de l'Alimentation CNRS, INRA, University Bourgogne Franche-Comte, Dijon, France
| | - Catherine Creuzot-Garcher
- Ophthalmology Department, University Hospital, Dijon, France.,Centre des Science du Gout et de l'Alimentation CNRS, INRA, University Bourgogne Franche-Comte, Dijon, France
| | - Yves Cottin
- Cardiology Department, University Hospital, Dijon, France.,PEC 2, University Bourgogne Franche-Comte, Dijon, France
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Kane SC, Brennecke SP, da Silva Costa F. Ophthalmic artery Doppler analysis: a window into the cerebrovasculature of women with pre-eclampsia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:15-21. [PMID: 27485824 DOI: 10.1002/uog.17209] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/22/2016] [Indexed: 05/27/2023]
Affiliation(s)
- S C Kane
- University of Melbourne, Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia
- Pregnancy Research Centre, Department of Maternal Fetal Medicine, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - S P Brennecke
- University of Melbourne, Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia
- Pregnancy Research Centre, Department of Maternal Fetal Medicine, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - F da Silva Costa
- University of Melbourne, Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia
- Perinatal Services, Monash Health, Clayton, Victoria, Australia
- Monash Ultrasound for Women, Clayton, Victoria, Australia
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Altinkaynak H, Kara N, Sayın N, Güneş H, Avşar S, Yazıcı AT. Subfoveal choroidal thickness in patients with chronic heart failure analyzed by spectral-domain optical coherence tomography. Curr Eye Res 2014; 39:1123-8. [PMID: 24749809 DOI: 10.3109/02713683.2014.898310] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the subfoveal choroidal thickness (SFCT) measured by enhanced depth imaging optical coherence tomography (EDI-OCT) in eyes of chronic heart failure (CHF) patients. METHODS Fifty-six patients with CHF and 56 age- and gender-matched healthy individuals were enrolled. The SFCT was measured by EDI-OCT. The ejection fraction of left ventricle (EFLV), age, intraocular pressure (IOP), axial length (AL), systolic and diastolic blood pressure, and ocular perfusion pressure (OPP) were also measured. RESULTS Mean SFCT was 181.2 ± 80.23 μm in the study group and 283.6 ± 52.4 μm in the control group (p = 0.000). There was a statistically significant correlation between the SFCT and each of EFLV and age. SFCT value was not statistically significantly associated with AL, IOP and OPP. CONCLUSION Our results suggest that SFCT is lower in eyes of CHF patients compared to age- and gender-matched healthy individuals.
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Affiliation(s)
- Hasan Altinkaynak
- Department of Ophthalmology, Ankara Atatürk Education and Research Hospital , Ankara , Turkey
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Meira-Freitas D, Melo LAS, Almeida-Freitas DB, Paranhos A. Glaucomatous optic nerve head alterations in patients with chronic heart failure. Clin Ophthalmol 2012; 6:623-9. [PMID: 22570542 PMCID: PMC3346190 DOI: 10.2147/opth.s30038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the association between chronic heart failure (CHF) and optic nerve head alterations. Methods A cross-sectional study was performed. Heart failure patients with recent echocardiograms were subjected to ophthalmologic examinations, including intraocular pressure measurement, optic nerve head, and retinal nerve fiber layer evaluation using stereophotography, Heidelberg retinal tomography, and standard automated perimetry. The ocular findings were correlated with the cardiological evaluation, and compared with a control group without cardiopathy. Results A total of 30 patients with CHF and 30 individuals without cardiopathy were enrolled in this study. The mean (standard deviation [SD]) intraocular pressure was 12.3 (2.5) mmHg in the CHF group, and 14.7 (2.9) mmHg in the control group (P < 0.001). The mean (SD) arterial blood pressure was 86.9 (17.1) mmHg in the CHF group, and 103.6 (15.2) mmHg in the control group (P < 0.001). The mean (SD) ocular perfusion pressure was 45.6 (11.1) mmHg in the CHF group, and 54.4 (10.4) mmHg in the control group (P = 0.001). The mean (SD) rim area was 1.41 (0.3) mm2 in the CHF group, and 1.60 (0.26) mm2 in the control group (P = 0.003). The mean (SD) vertical cup/disc ratio was 0.51 (0.17) in the CHF group, and 0.41 (0.18) in the control group (P = 0.02). The Moorfields regression analysis was outside the normal limits in 16 out of 58 (27.6%) eyes of the CHF subjects, and in 4 out of 60 (6.7%) eyes of the control subjects (P = 0.01). The frequency of glaucoma was 10% in the CHF group, whereas none of the control subjects met the criteria for the diagnosis of glaucoma (P = 0.24). Conclusion CHF is associated with lower ocular perfusion pressure, and glaucomatous optic nerve head changes.
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Affiliation(s)
- Daniel Meira-Freitas
- Department of Ophthalmology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
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