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Lu B, Li Y, Xie L, Chiu K, Hao X, Xu J, Luo J, Sham PC. Computational Retinal Microvascular Biomarkers from an OCTA Image in Clinical Investigation. Biomedicines 2024; 12:868. [PMID: 38672222 PMCID: PMC11048516 DOI: 10.3390/biomedicines12040868] [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: 12/25/2023] [Revised: 03/24/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Retinal structural and functional changes in humans can be manifestations of different physiological or pathological conditions. Retinal imaging is the only way to directly inspect blood vessels and their pathological changes throughout the whole body non-invasively. Various quantitative analysis metrics have been used to measure the abnormalities of retinal microvasculature in the context of different retinal, cerebral and systemic disorders. Recently developed optical coherence tomography angiography (OCTA) is a non-invasive imaging tool that allows high-resolution three-dimensional mapping of the retinal microvasculature. The identification of retinal biomarkers from OCTA images could facilitate clinical investigation in various scenarios. We provide a framework for extracting computational retinal microvasculature biomarkers (CRMBs) from OCTA images through a knowledge-driven computerized automatic analytical system. Our method allows for improved identification of the foveal avascular zone (FAZ) and introduces a novel definition of vessel dispersion in the macular region. Furthermore, retinal large vessels and capillaries of the superficial and deep plexus can be differentiated, correlating with retinal pathology. The diagnostic value of OCTA CRMBs was demonstrated by a cross-sectional study with 30 healthy subjects and 43 retinal vein occlusion (RVO) patients, which identified strong correlations between OCTA CRMBs and retinal function in RVO patients. These OCTA CRMBs generated through this "all-in-one" pipeline may provide clinicians with insights about disease severity, treatment response and prognosis, aiding in the management and early detection of various disorders.
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Affiliation(s)
- Bingwen Lu
- Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China;
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Yiming Li
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (Y.L.); (P.-C.S.)
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Like Xie
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Kin Chiu
- Department of Ophthalmology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China;
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaofeng Hao
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Jing Xu
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Jie Luo
- Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
| | - Pak-Chung Sham
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (Y.L.); (P.-C.S.)
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
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Huang Y, Cheung CY, Li D, Tham YC, Sheng B, Cheng CY, Wang YX, Wong TY. AI-integrated ocular imaging for predicting cardiovascular disease: advancements and future outlook. Eye (Lond) 2024; 38:464-472. [PMID: 37709926 PMCID: PMC10858189 DOI: 10.1038/s41433-023-02724-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 07/26/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of death worldwide. Assessing of CVD risk plays an essential role in identifying individuals at higher risk and enables the implementation of targeted intervention strategies, leading to improved CVD prevalence reduction and patient survival rates. The ocular vasculature, particularly the retinal vasculature, has emerged as a potential means for CVD risk stratification due to its anatomical similarities and physiological characteristics shared with other vital organs, such as the brain and heart. The integration of artificial intelligence (AI) into ocular imaging has the potential to overcome limitations associated with traditional semi-automated image analysis, including inefficiency and manual measurement errors. Furthermore, AI techniques may uncover novel and subtle features that contribute to the identification of ocular biomarkers associated with CVD. This review provides a comprehensive overview of advancements made in AI-based ocular image analysis for predicting CVD, including the prediction of CVD risk factors, the replacement of traditional CVD biomarkers (e.g., CT-scan measured coronary artery calcium score), and the prediction of symptomatic CVD events. The review covers a range of ocular imaging modalities, including colour fundus photography, optical coherence tomography, and optical coherence tomography angiography, and other types of images like external eye images. Additionally, the review addresses the current limitations of AI research in this field and discusses the challenges associated with translating AI algorithms into clinical practice.
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Affiliation(s)
- Yu Huang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Dawei Li
- College of Future Technology, Peking University, Beijing, China
| | - Yih Chung Tham
- Centre for Innovation and Precision Eye Health and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Ching Yu Cheng
- Centre for Innovation and Precision Eye Health and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore.
- Tsinghua Medicine, Tsinghua University, Beijing, China.
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China.
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Li R, Hui Y, Li J, Zhang X, Zhang S, Lv B, Ni Y, Li X, Liang X, Yang L, Lv H, Li H, Yang Y, Liu G, Xie G, Wu S, Wang Z. The association of global vessel width with cognitive decline and cerebral small vessel disease burden in the KaiLuan study. Quant Imaging Med Surg 2024; 14:932-943. [PMID: 38223087 PMCID: PMC10784051 DOI: 10.21037/qims-23-927] [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: 06/27/2023] [Accepted: 11/10/2023] [Indexed: 01/16/2024]
Abstract
Background As the retinal microvasculature shares similarities with the cerebral microvasculature, numerous studies have shown that retinal vascular is associated with cognitive decline. In addition, several population-based studies have confirmed the association between retinal vascular and cerebral small vessel disease (CSVD) burden. However, the association of retinal vascular with CSVD burden as well as cognitive function has not been explored simultaneously. This study investigated the relations of retinal microvascular parameters (RMPs) with CSVD burden and cognitive function. Methods We conducted a cross-sectional study of participants in the KaiLuan study. Data were collected from subjects aged ≥18 years old who could complete retinal photography and brain magnetic resonance imaging (MRI) between December 2020 to October 2021 in the Kailuan community of Tangshan. RMPs were evaluated using a deep learning system. The cognitive function was measured using the Montreal Cognitive Assessment (MoCA). We conducted logistic regression models, and mediation analysis to evaluate the associations of RMPs with CSVD burden and cognitive decline. Results Of the 905 subjects (mean age: 55.42±12.02 years, 54.5% female), 488 (53.9%) were classified with cognitive decline. The fractal dimension (FD) [odds ratio (OR), 0.098, 95% confidence interval (CI): 0.015-0.639, P=0.015] and global vein width (OR: 1.010, 95% CI: 1.005-1.015, P<0.001) were independent risk factors for cognitive decline after adjustment for potential confounding factors. The global artery width was significantly associated with severe CSVD burden (OR: 0.985, 95% CI: 0.974-0.997, P=0.013). The global vein width was sightly associated with severe CSVD burden (OR: 1.005, 95% CI: 1.000-1.010, P=0.050) after adjusting for potential confounders. The multivariable-adjusted odds ratios (95% CI) in highest tertile versus lowest tertile of global vein width were 1.290 (0.901-1.847) for cognitive decline and 1.546 (1.004-2.290) for severe CSVD burden, respectively. Moreover, CSVD burden played a partial mediating role in the association between global vein width and cognitive function (mediating effect 6.59%). Conclusions RMPs are associated with cognitive decline and the development of CSVD. A proportion of the association between global vein width and cognitive decline may be attributed to the presence of CSVD burden.
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Affiliation(s)
- Rui Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying Hui
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | | | - Shun Zhang
- Department of Psychiatry, Kailuan Mental Health Centre, Tangshan, China
| | - Bin Lv
- Ping An Healthcare Technology, Beijing, China
| | - Yuan Ni
- Ping An Healthcare Technology, Beijing, China
| | - Xiaoshuai Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaoliang Liang
- Department of Psychiatry, Kailuan Mental Health Centre, Tangshan, China
| | - Ling Yang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongyang Li
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yingping Yang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangfeng Liu
- Department of Ophthalmology, Peking University International Hospital, Beijing, China
| | - Guotong Xie
- Ping An Healthcare Technology, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Kwapong WR, Cao L, Pan R, Wang H, Ye C, Tao W, Liu J, Wu B. Retinal microvascular and structural changes in intracranial hypertension patients correlate with intracranial pressure. CNS Neurosci Ther 2023; 29:4093-4101. [PMID: 37287365 PMCID: PMC10651994 DOI: 10.1111/cns.14298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
AIMS We aimed to evaluate the retinal microvascular and structural changes in intracranial hypertension (IH) patients compared with an age- and sex-matched control group. We also investigated the association between clinical parameters and retinal changes in IH patients. METHODS Intracranial hypertension patients were divided into eyes with papilledema (IH-P) and eyes without papilledema (IH-WP). IH patients underwent lumbar puncture to measure intracranial pressure (ICP); visual acuity was performed using the Snellen chart. Optical coherence tomography (OCT) was used to image and measure the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) while OCT angiography was used to image and measure the superficial vascular complex (SVC) and deep vascular complex (DVC). RESULTS Intracranial hypertension patients showed reduced microvascular densities and thinner retinal thicknesses compared with the control group (all p < 0.001). Compared with the control group, IH-P showed reduced microvascular densities and thinner retinal thicknesses (all p < 0.001). IH-P showed reduced SVC density and thinner retinal thicknesses when compared with IH-WP (p = 0.008 for SVC, p = 0.025 for RNFL, and p = 0.018 for GCIPL). ICP correlated with the microvascular densities and GCIPL thickness in IH patients (p = 0.025 for GCIPL, p = 0.004 for SVC, and p = 0.002 for DVC). A significant association of ICP with SVC (p = 0.010) and DVC (p = 0.005) densities were also found in IH-P. CONCLUSIONS Given the observed differences in these noninvasive retinal imaging markers, further research into their clinical utility in IH is needed.
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Affiliation(s)
| | - Le Cao
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Ruosu Pan
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Hang Wang
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Chen Ye
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Wendan Tao
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Junfeng Liu
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Bo Wu
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
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Liu J, Tao W, Guo X, Kwapong WR, Ye C, Wang A, Wu X, Wang Z, Liu M. The Association of Retinal Microvasculature With Gray Matter Changes and Structural Covariance Network: A Voxel-Based Morphometry Study. Invest Ophthalmol Vis Sci 2023; 64:40. [PMID: 38153752 PMCID: PMC10756243 DOI: 10.1167/iovs.64.15.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose Increasing evidence suggests that retinal microvasculature may reflect global cerebral atrophy. However, little is known about the relation of retinal microvasculature with specific brain regions and brain networks. Therefore, we aimed to unravel the association of retinal microvasculature with gray matter changes and structural covariance network using a voxel-based morphometry (VBM) analysis. Methods One hundred and forty-four volunteers without previously known neurological diseases were recruited from West China Hospital, Sichuan University between April 1, 2021, and December 31, 2021. Retinal microvasculature of superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) were measured by optical coherence tomography angiography using an automatic segmentation. The VBM and structural covariance network analyses were applied to process brain magnetic resonance imaging (MRI) images. The associations of retinal microvasculature with voxel-wise gray matter volumes and structural covariance network were assessed by linear regression models. Results In the study, 137 participants (mean age = 59.72 years, 37.2% men) were included for the final analysis. Reduced perfusion in SVP was significantly associated with reduced voxel-wise gray matter volumes of the brain regions including the insula, putamen, occipital, frontal, and temporal lobes, all of which were located in the anterior part of the brain supplied by internal carotid artery, except the occipital lobe. In addition, these regions were also involved in visual processing and cognitive impairment (such as left inferior occipital gyrus, left lingual gyrus, and right parahippocampal gyrus). In regard to the structural covariance, the perfusions in SVP were positively related to the structural covariance of the left lingual gyrus seed with the left middle occipital gyrus, the right middle occipital gyrus, and the left middle frontal gyrus. Conclusions Poor perfusion in SVP was correlated with reduced voxel-wise gray matter volumes and structural covariance networks in regions related to visual processing and cognitive impairment. It suggests that retinal microvasculature may offer a window to identify aging related cerebral alterations.
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Affiliation(s)
- Junfeng Liu
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Wendan Tao
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Xiaonan Guo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - William Robert Kwapong
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Anmo Wang
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Xinmao Wu
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Zhetao Wang
- Department of Radiology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
| | - Ming Liu
- Department of Neurology, West China Hospital, Sichuan University China, Chengdu, Sichuan Province, China
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Wang R, Wu X, Zhang Z, Cao L, Kwapong WR, Wang H, Tao W, Ye C, Liu J, Wu B. Retinal ganglion cell-inner plexiform layer, white matter hyperintensities, and their interaction with cognition in older adults. Front Aging Neurosci 2023; 15:1240815. [PMID: 38035269 PMCID: PMC10685347 DOI: 10.3389/fnagi.2023.1240815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose We explored the interaction of optical coherence tomography (OCT) parameters and white matter hyperintensities with cognitive measures in our older adult cohort. Methods This observational study enrolled participants who underwent a comprehensive neuropsychological battery, structural 3-T brain magnetic resonance imaging (MRI), visual acuity examination, and OCT imaging. Cerebral small vessel disease (CSVD) markers were read on MR images; lacune, cerebral microbleeds (CMB), white matter hyperintensities (WMH), and enlarged perivascular spaces (EPVS), were defined according to the STRIVE standards. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses (μm) were measured on the OCT tool. Results Older adults with cognitive impairment (CI) showed lower RNFL (p = 0.001), GCIPL (p = 0.009) thicknesses, and lower hippocampal volume (p = 0.004) when compared to non-cognitively impaired (NCI). RNFL (p = 0.006) and GCIPL thicknesses (p = 0.032) correlated with MoCA scores. GCIPL thickness (p = 0.037), total WMH (p = 0.003), PWMH (p = 0.041), and DWMH (p = 0.001) correlated with hippocampal volume in our older adults after adjusting for covariates. With hippocampal volume as the outcome, a significant interaction (p < 0.05) between GCIPL and PWMH and total WMH was observed in our older adults. Conclusion Both GCIPL thinning and higher WMH burden (especially PWMH) are associated with hippocampal volume and older adults with both pathologies are more susceptible to subclinical cognitive decline.
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Affiliation(s)
- Ruilin Wang
- Ophthalmology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Xinmao Wu
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Zengyi Zhang
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Le Cao
- Ophthalmology Department, West China Hospital, Sichuan University, Chengdu, China
| | | | - Hang Wang
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Wendan Tao
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Chen Ye
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Junfeng Liu
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Neurology Department, West China Hospital, Sichuan University, Chengdu, China
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Xu Z, Dong Y, Wang Y, Song L, Niu S, Wang S, Zhao M, Wang J, Cong L, Han X, Hou T, Tang S, Zhang Q, Du Y, Qiu C. Associations of macular microvascular parameters with cerebral small vessel disease in rural older adults: A population-based OCT angiography study. Front Neurol 2023; 14:1133819. [PMID: 37006481 PMCID: PMC10060796 DOI: 10.3389/fneur.2023.1133819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo explore the associations of macular microvascular parameters with cerebral small vessel disease (CSVD) in rural-dwelling older adults in China.MethodsThis population-based cross-sectional study included 195 participants (age ≥ 60 years; 57.4% women) in the optical coherence tomographic angiography (OCTA) sub-study within the Multimodal Interventions to delay Dementia and disability in rural China (MIND-China). Macular microvascular parameters were measured using the OCTA. We automatically estimated volumes of gray matter, white matter, and white matter hyperintensity (WMH), and manually assessed numbers of enlarged perivascular spaces (EPVS) and lacunes on brain magnetic resonance imaging. Data were analyzed with the general linear models.ResultsAdjusting for multiple confounders, lower vessel skeleton density (VSD) and higher vessel diameter index (VDI) were significantly associated with larger WMH volume (P < 0.05). Lower VSD and foveal density-300 (FD-300) of left eye were significantly associated with lower brain parenchymal volume (P < 0.05). In addition, lower areas of foveal avascular zone (FAZ) and FD-300 of left eye were significantly associated with more EPVS (P < 0.05). The associations of abnormal macular microvascular parameters with WMH volume were evident mainly among females. Macular microvascular parameters were not associated with lacunes.ConclusionMacular microvascular signs are associated with WMH, brain parenchymal volume, and EPVS in older adults. The OCTA-assessed macular microvascular parameters can be valuable markers for microvascular lesions in the brain.
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Affiliation(s)
- Zhe Xu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Sijie Niu
- Shandong Provincial Key Laboratory of Network Based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan, Shandong, China
| | - Shanshan Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Mingqing Zhao
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jiafeng Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Xiaojuan Han
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
- *Correspondence: Qinghua Zhang
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
- Yifeng Du
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Lang Y, Kwapong WR, Kong L, Shi Z, Wang X, Du Q, Wu B, Zhou H. Retinal structural and microvascular changes in myelin oligodendrocyte glycoprotein antibody disease and neuromyelitis optica spectrum disorder: An OCT/OCTA study. Front Immunol 2023; 14:1029124. [PMID: 36793713 PMCID: PMC9923098 DOI: 10.3389/fimmu.2023.1029124] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/04/2023] [Indexed: 01/31/2023] Open
Abstract
Purpose To compare the optical coherence tomography (OCT)/OCT angiography (OCTA) measures in patients with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). Methods Twenty-one MOG, 21 NMOSD, and 22 controls were enrolled in our study. The retinal structure [retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL)] was imaged and assessed with the OCT; OCTA was used to image the macula microvasculature [superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP)]. Clinical information such as disease duration, visual acuity, and frequency of optic neuritis and disability was recorded for all patients. Results Compared with NMOSD patients, MOGAD patients showed significantly reduced SVP density (P = 0.023). No significant difference (P > 0.05) was seen in the microvasculature and structure when NMOSD-ON was compared with MOG-ON. In NMOSD patients, EDSS, disease duration, reduced visual acuity, and frequency of ON significantly correlated (P < 0.05) with SVP and ICP densities; in MOGAD patients, SVP correlated with EDSS, duration, reduced visual acuity, and frequency of ON (P < 0.05), while DCP density correlated with disease duration, visual acuity, and frequency of ON. Conclusions Distinct structural and microvascular changes were identified in MOGAD patients compared with NMOSD patients suggesting that the pathological mechanisms are different in NMOSD and MOGAD. Retinal imaging via the SS-OCT/OCTA might have the potential to be used as a clinical tool to evaluate the clinical features associated with NMOSD and MOGAD.
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Affiliation(s)
| | | | | | | | | | | | - Bo Wu
- *Correspondence: Hongyu Zhou, ; Bo Wu,
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Tao W, Liu J, Ye C, Kwapong WR, Wang A, Wang Z, Chen S, Liu M. Relationships between cerebral small vessel diseases markers and cognitive performance in stroke-free patients with atrial fibrillation. Front Aging Neurosci 2023; 14:1045910. [PMID: 36688147 PMCID: PMC9846141 DOI: 10.3389/fnagi.2022.1045910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background Atrial fibrillation (AF) is related to an increased risk of cognitive dysfunction. Besides clinically overt stroke, AF can damage the brain via several pathophysiological mechanisms. We aimed to assess the potential mediating role of cerebral small vessel disease (SVD) and cognitive performance in individuals with AF. Methods Stroke-free individuals with AF from the cardiological outpatient clinic at West China Hospital of Sichuan University were recruited. Extensive neuropsychological testing tools were assessed including global function, domains of attention, executive functions, learning, and memory. 3 T magnetic resonance imaging (MRI) was used for SVD markers assessment of white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVS). The correlation between SVD markers and cognitive measures was analyzed by multivariate linear regression models. Results We finally enrolled 158 participants, of whom 95 (60.1%) were males. In multivariate models, the presence of lacunes independently associated with Montreal Cognitive Assessment (Model 1: ß = 0.52, Model 2: ß = 0.55), Rey Auditory Verbal Learning Test-immediate and delayed recall (Model 1: ß = 0.49; ß = 0.69; Model 2: ß = 0.53; ß = 0.73) as well as Stroop-Acorrect (Model 1: ß = 0.12; Model 2: ß = 0.13), while total WMH severity independently associated with Strooptime-A (Model 1: ß = 0.24; Model 3: ß = 0.27), Strooptime-B (Model 1: ß = 0.17; Model 3: ß = 0.17), Strooptime-C (Model 1: ß = 0.22; Model 3: ß = 0.21) and Shape Trail Test-A (Model 1: ß = 0.17; Model 3: ß = 0.16). Conclusion In our cohort of stroke-free individuals with AF, lacunes, and WMHs were independently associated with cognitive decline while EPVS and CMBs did not show significance. Assessment of SVD MRI markers might be valuable for cognition risk stratification and facilitate optimal management of patients with AF.
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Affiliation(s)
- Wendan Tao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Junfeng Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Anmo Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhetao Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Shi Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China,Shi Chen, ✉
| | - Ming Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Ming Liu, ✉
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Wang R, Kwapong WR, Tao W, Cao L, Ye C, Liu J, Zhang S, Wu B. Association of retinal thickness and microvasculature with cognitive performance and brain volumes in elderly adults. Front Aging Neurosci 2022; 14:1010548. [PMID: 36466601 PMCID: PMC9709407 DOI: 10.3389/fnagi.2022.1010548] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/27/2022] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Retinal structural and microvascular changes can be visualized and have been linked with cognitive decline and brain changes in cerebral age-related disorders. We investigated the association between retinal structural and microvascular changes with cognitive performance and brain volumes in elderly adults. MATERIALS AND METHODS All participants underwent magnetic resonance imaging (MRI), and a battery of neuropsychological examinations. Macula retinal thicknesses (retinal nerve fiber layer, mRNFL, and ganglion cell-inner plexiform layer, GCIPL) were imaged and measured with swept-source optical coherence tomography (SS-OCT) while Optical Coherence Tomography Angiography (OCTA) imaged and measured the superficial vascular complex (SVC) and deep vascular complex (DVC) of the retina. RESULTS Out of the 135 participants, 91 (67.41%) were females and none had dementia. After adjusting for risk factors, Shape Trail Test (STT)-A correlated with SVC (P < 0.001), DVC (P = 0.015) and mRNFL (P = 0.013) while STT-B correlated with SVC (P = 0.020) and GCIPL (P = 0.015). mRNFL thickness correlated with Montreal Cognitive Assessment (MoCA) (P = 0.007) and Stroop A (P = 0.030). After adjusting for risk factors and total intracranial volume, SVC correlated with hippocampal volume (P < 0.001). Hippocampal volume correlated (P < 0.05) with most cognitive measures. Stroop B (P < 0.001) and Stroop C (P = 0.020) correlated with white matter volume while Stroop measures and STT-A correlated with gray matter volume (P < 0.05). CONCLUSION Our findings suggest that the retinal structure and microvasculature can be useful pointers for cognitive performance, giving a choice for early discovery of decline in cognition and potential early treatment.
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Affiliation(s)
- Ruilin Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Wendan Tao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Le Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Chen Ye
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Junfeng Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Shuting Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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