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Lee JH, Kim JJ, Hong SY, Kim GH, Kim JY, Kim RY, Kim M, Park YG, Kim YJ, Cho BS, Lee S, Kim HJ, Park YH. Analysis of retinal and choroidal microvascular changes using optical coherence tomography and optical coherence tomography angiography in patients with acute leukemia. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06504-y. [PMID: 38713398 DOI: 10.1007/s00417-024-06504-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/19/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE Although leukemic retinopathy accounts for 80% of ocular complications in acute leukemia, its pathogenesis remains unclear. To evaluate changes in retinal and choroicapillaris and structural parameters in patients with acute leukemia, we analyzed the correlation between vascular perfusion metrics and laboratory parameters and assessed the changes after hematopoietic stem cell transplantation (HSCT). METHODS Herein, 104 eyes of 52 patients aged 18 and above with acute leukemia were enrolled. 80 eyes of 40 healthy patients were recruited as control participants. All participants underwent optical coherence tomography (OCT) and OCT angiography (OCTA) at baseline. RESULTS Patients with acute leukemia had a significantly thicker ganglion cell-inner plexiform layer (GCIPL) and lower circularity index than the control participants. Post-HSCT perfusion metrics did not differ significantly, but parafoveal thickness decreased significantly. During the active phase of acute leukemia, lower platelet levels were associated with significant GCIPL thickening and increased foveal avascular zone and perimeter. D-dimer levels positively correlated with GCIPL thickness. CONCLUSION Patients with acute leukemia had subclinical retinal microvascular deficits on OCTA and GCIPL thickening on OCT, possibly associated with bone marrow function. GCIPL thickness may indicate acute ischemia in such patients. Further studies must elucidate their clinical and prognostic significance.
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Affiliation(s)
- Ji Hye Lee
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Jae Jung Kim
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Seo Yeon Hong
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Gee-Hyun Kim
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Joo-Young Kim
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Rae-Young Kim
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Mirinae Kim
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Young-Geun Park
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea
| | - Yoo-Jin Kim
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung-Sik Cho
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seok Lee
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hee-Je Kim
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Hoon Park
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
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Majithia S, Chong CCY, Chee ML, Yu M, Soh ZD, Thakur S, Lavanya R, Rim TH, Nusinovici S, Koh V, Sabanayagam C, Cheng CY, Tham YC. Associations between Chronic Kidney Disease and Thinning of Neuroretinal Layers in Multiethnic Asian and White Populations. Ophthalmol Sci 2024; 4:100353. [PMID: 37869020 PMCID: PMC10587624 DOI: 10.1016/j.xops.2023.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/22/2023] [Accepted: 06/14/2023] [Indexed: 10/24/2023]
Abstract
Purpose To evaluate the relationships between chronic kidney disease (CKD) with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness profiles of eyes in Asian and White populations. Design Cross-sectional analysis. Participants A total of 5066 Asian participants (1367 Malays, 1772 Indians, and 1927 Chinese) from the Singapore Epidemiology of Eye Diseases Study (SEED) were included, consisting of 9594 eyes for peripapillary RNFL analysis and 8661 eyes for GCIPL analysis. Additionally, 45 064 White participants (87 649 eyes) from the United Kingdom Biobank (UKBB) were included for both macular RNFL analysis and GCIPL analysis. Methods Nonglaucoma participants aged ≥ 40 years with complete data for estimated glomerular filtration rate (eGFR) were included from both SEED and UKBB. In SEED, peripapillary RNFL and GCIPL thickness were measured by Cirrus HD-OCT 4000. In UKBB, macular RNFL and GCIPL were measured by Topcon 3D-OCT 1000 Mark II. Chronic kidney disease was defined as eGFR < 60 ml/min/1.73 m2 in both data sets. To evaluate the associations between kidney function status with RNFL and GCIPL thickness profiles, multivariable linear regression with generalized estimating equation models were performed in SEED and UKBB data sets separately. Main Outcome Measures Average peripapillary and macular RNFL thickness and macular GCIPL thickness. Results In SEED, after adjusting for age, gender, ethnicity, systolic blood pressure, antihypertensive medication, diabetes, hyperlipidemia, body mass index, smoking status, and intraocular pressure, presence of CKD (β = -1.31; 95% confidence interval [CI], -2.37 to -0.26; P = 0.015) and reduced eGFR (per 10 ml/min/1.73 m2; β = -0.32; 95% CI, -0.50 to -0.13; P = 0.001) were associated with thinner average peripapillary RNFL. Presence of CKD (β = -1.63; 95% CI, -2.42 to -0.84) and reduced eGFR (per 10 ml/min/1.73 m2; β = -0.30; 95% CI, -0.44 to -0.16) were consistently associated with thinner GCIPL in SEED (all P < 0.001). In UKBB, after adjusting for the above-mentioned covariates (except ethnicity), reduced eGFR (per 10 ml/min/1.73 m2; β = -0.06; 95% CI, -0.10 to -0.01; P = 0.008) was associated with thinner macular RNFL and CKD (β = -0.62; 95% CI, -1.16 to -0.08; P = 0.024) was associated with thinner average GCIPL. Conclusion We consistently observed associations between CKD and thinning of RNFL and GCIPL across Asian and White populations' eyes. These findings further suggest that compromised kidney function is associated with RNFL and GCIPL thinning. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Raghavan Lavanya
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Victor Koh
- Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ophthalmology, National University Hospital, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Coskun C, Coskun Y. Evaluation of optic coherence tomography findings in patients with inflammatory bowel disease. Photodiagnosis Photodyn Ther 2023; 44:103788. [PMID: 37666381 DOI: 10.1016/j.pdpdt.2023.103788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Ocular complications are known to appear in inflammatory bowel disease (IBD). Among these, posterior segment complications can lead to substantial morbidity. The aim of the study is to evaluate the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and macula thickness measurement in patients with IBD. METHODS A total of 118 patients with IBD (42 Crohn's disease (CD), 76 ulcerative colitis (UC)) and 52 healthy subjects were included in the study. RNFL, GCIPL, and macula thickness were measured using spectral-domain optical coherence tomography (SD-OCT). RESULTS The central macular thickness was increased, mean and all superior quadrants of GCIPL thickness measurements were significantly decreased, but RNFL thickness wasn't changed in CD compared to healthy subjects. Although the central macular thickness increased, no change was observed in mean RNFL and GCIPL in UC compared to healthy subjects. Mean RNFL, GCIPL, and macular thickness did not differ during the remission and active phases of the disease in IBD. There was no difference in RNFL, GCIPL, and macular thicknesses in CD patients in terms of the location and behavior of the disease. A significant thickness increase was found in extensive type UC for inferior RNFL value compared to the left side and proctitis. CONCLUSIONS IBD may cause an increase in macular thickness. This finding may be related to the inflammation or ischemia of the retina. The use of SD-OCT in ophthalmologic examination in patients with IBD may enable early detection of retinal changes and alert the clinician to complications of IBD.
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Affiliation(s)
- Cigdem Coskun
- Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, Turkey.
| | - Yusuf Coskun
- Department of Gastroenterology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
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Zheng Z, Yan M, Zhang D, Li L, Zhang L. Quantitatively Evaluating the Relationships between Insulin Resistance and Retinal Neurodegeneration with Optical Coherence Tomography in Early Type 2 Diabetes Mellitus. Ophthalmic Res 2023; 66:968-977. [PMID: 37271122 DOI: 10.1159/000530904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/21/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The aim of this study was to quantitatively assess retinal neurodegenerative changes with optical coherence tomography (Cirrus HD-OCT) in type 2 diabetes mellitus (T2DM) patients without diabetic retinopathy (DR) and evaluate their relationships with insulin resistance (IR) and associated systemic indicators. METHODS 102 T2DM patients without DR and 48 healthy controls were included in this observational cross-sectional study. The OCT parameters of macular retinal thickness (MRT) and ganglion cell-inner plexiform layer (GCIPL) thicknesses were evaluated between diabetic and normal eyes. The receiver operating characteristics (ROC) curve was generated to evaluate the discrimination power of early diabetes. Correlation and multiple regression analysis were performed between ophthalmological parameters and T2DM-related demographic and anthropometric variables, and serum biomarkers and homeostasis model assessment of insulin resistance (HOMA-IR) scores. RESULTS MRT and GCIPL thicknesses showed significant thinning in patients, especially in inferotemporal area. High body mass index (BMI) correlated with decreased GCIPL thicknesses and elevated intraocular pressure (IOP). A negative correlation between waist-to-hip circumference ratio (WHR) and GCIPL thicknesses was also found. High-density lipoprotein (HDL) and fasting C-peptide (CP0) were associated with GCIPL thickness but only in inferotemporal region (r = 0.20, p = 0.04; r = -0.20, p = 0.05, respectively). Multiple regression analysis showed that increased HOMA-IR scores independently predicted both average (β = -0.30, p = 0.05) and inferotemporal (β = -0.34, p = 0.03) GCIPL thinning. CONCLUSION Retinal thinning in early T2DM was associated with obesity-related metabolic disorders. IR as an independent risk factor for retinal neurodegeneration may increase the risk of developing glaucoma.
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Affiliation(s)
- Zhaoxia Zheng
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Meng Yan
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Duo Zhang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lu Li
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lina Zhang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Kumar A, Moharana B, Katoch D, Singh R. Papillomacular bundle sparing versus conventional internal limiting membrane peeling for idiopathic macular hole ≤400 μm. Indian J Ophthalmol 2023; 71:927-932. [PMID: 36872711 DOI: 10.4103/ijo.ijo_1666_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Purpose To compare the outcomes of papillomacular bundle (PMB) sparing internal limiting membrane (ILM) peeling (group LP) and conventional ILM peeling (group CP) for treatment of idiopathic macular hole (MH) of ≤400 μm. Methods Fifteen eyes were included in each group. In group CP, conventional 360° peeling was done, while in group LP, ILM was spared over PMB. The changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness were analyzed at 3 months. Results MH was closed in all with comparable visual improvement. Postoperatively, retinal nerve fiber layer (RNFL) was significantly thinner in the temporal quadrant in group CP. GC-IPL was significantly thinner in the temporal quadrants in group LP, whereas it was comparable in group CP. Conclusion PMB sparing ILM peeling is comparable to conventional ILM peeling in terms of closure rate and visual gain, with the advantage of less retinal damage at 3 months.
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Affiliation(s)
- Aman Kumar
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bruttendu Moharana
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deeksha Katoch
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramandeep Singh
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sheng WY, Wu SQ, Su LY, Zhu LW. Ethambutol-induced optic neuropathy with rare bilateral asymmetry onset: A case report. World J Clin Cases 2022; 10:663-670. [PMID: 35097092 PMCID: PMC8771374 DOI: 10.12998/wjcc.v10.i2.663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/12/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ethambutol-induced optic neuropathy (EON) most commonly manifests as bilateral symmetrical loss of vision and often cause serious and irreversible visual impairment because of the lack of early detection and effective treatment. We followed a case of EON with rare binocular asymmetric clinical manifestations and observed the changes of visual function and retinal structure after drug withdrawal, so as to further understand the clinical characteristics of this disease.
CASE SUMMARY A 54-year-old man complained of gradual visual decline in the left eye. The patient presented with best-corrected visual acuity of 20/20 in the right eye and 20/50 in the left eye. Color vision examination revealed difficulty in reading green color plates in the left eye. The visual field manifested as concentric contraction in the left eye. After nearly a month of drug withdrawal, the right eye had a similar decline in visual function. At the last visit, 19 mo after drug withdrawal, the visual function significantly recovered in both eyes. During follow-up optical coherence tomography (OCT) examination, both eyes manifested the thickness of the retinal nerve fiber layer from mild thickening to thinning and finally temporal atrophy, and the ganglion cell-inner plexiform layer showed significant thinning. The difference was that a reversible structural disorder in the outer retina of the nasal macula was detected in the left eye by macular high-definition OCT.
CONCLUSION Nephropathy and high blood pressure, which damage the retinal microcirculation, may cause damage to the outer layer of the retina. Ethambutol may influence photoreceptor as well as retinal ganglion cells.
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Affiliation(s)
- Wen-Yan Sheng
- Department of Ophthalmology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Shuang-Qing Wu
- Department of Ophthalmology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Ling-Ya Su
- Department of Ophthalmology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Li-Wei Zhu
- Department of Ophthalmology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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Tong J, Yoshioka N, Alonso-Caneiro D, Zangerl B. Ganglion cell-inner plexiform layer measurements derived from widefield compared to montaged 9-field optical coherence tomography. Clin Exp Optom 2021; 105:822-830. [PMID: 34791988 DOI: 10.1080/08164622.2021.1993058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE With equivalent inner retinal thickness measurements compared to a more conventional composite optical coherence tomography (OCT) protocol, Widefield optical coherence tomography (WF-OCT) is a clinically viable, time-saving option facilitating detection of ocular pathologies within the central 55° of the retina. PURPOSE To compare ganglion cell-inner plexiform layer (GCIPL) thicknesses obtained using a single WF-OCT scan and standard composite OCT scans acquired in 9 fields of gaze (9F-OCT). METHODS Thirteen healthy participants underwent WF-OCT and 9F-OCT using the Spectralis OCT. The GCIPL was automatically segmented with a manual review for 9F-OCT and was manually segmented for WF-OCT. After registration, differences in GCIPL thicknesses were compared using 95% confidence intervals computed from one-sample t-tests and Bland-Altman analyses. Location-specific differences in B-scan tilt were analysed using Spearman correlations and linear regression models. To determine whether B-scan tilt influences GCIPL measurements, regression models of tilt versus differences between perpendicular and axial GCIPL thickness were applied. RESULTS While scattered locations demonstrated significant GCIPL thickness differences between WF-OCT and 9F-OCT, most differences did not exceed the axial pixel resolution of the instrument of 3.87 µm. Bland-Altman analyses indicated no notable bias using WF-OCT. Moderate correlations indicating significant location-specific differences in B-scan tilt were observed for temporal, central and inferior B-scans (r = -0.62 to 0.72), with linear regression models predicting a maximum difference in the tilt of 4.65°. The quadratic regression model indicated that at tilts greater than 27.3°, perpendicular GCIPL measurements become increasingly thin relative to axial measurements. CONCLUSIONS GCIPL thicknesses and B-scan tilts from WF-OCT are comparable to 9F-OCT, indicating that WF-OCT can be applied clinically to obtain valid inner retinal OCT measurements over 55° of the central retina with relative ease. However, for peripheral locations, B-scan tilt may need to be considered when measuring GCIPL thicknesses.
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Affiliation(s)
- Janelle Tong
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, Australia.,School of Optometry and Vision Science, UNSW, Sydney, Australia
| | - Nayuta Yoshioka
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, Australia
| | - David Alonso-Caneiro
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Barbara Zangerl
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, Australia.,School of Optometry and Vision Science, UNSW, Sydney, Australia
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Deshpande GA, Gupta R, Bawankule P, Raje D, Chakraborty M. Evaluation of ganglion cell-inner plexiform layer thickness in the diagnosis of preperimetric glaucoma and comparison to retinal nerve fiber layer. Indian J Ophthalmol 2021; 69:1113-1119. [PMID: 33913844 PMCID: PMC8186640 DOI: 10.4103/ijo.ijo_965_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the diagnostic ability of optic nerve head (ONH), RNFL, and GC-IPL parameters in differentiating eyes with PPG from normals. Methods: This was a retrospective, cross-sectional, observational study. We studied 73 eyes of 41 patients and compared them to 65 eyes of 34 normal persons. Each patient underwent detailed ocular examination, standard automated perimetry, GC-IPL, ONH, and RNFL analysis. PPG was defined as eyes with normal visual field results and one or more localized RNFL defects that were associated with a glaucomatous disc appearance (e.g., notching or thinning of neuroretinal rim) and IOP more than 21 mm Hg. Diagnostic abilities of GC-IPL, ONH, and RNFL parameters were computed using area under receiver-operating curve (AUROC), sensitivity and specificity, and likelihood ratios (LRs). Results: All GC-IPL parameters differed significantly from normal. The ONH, RNFL, and GC-IPL parameters with best area under curves (AUCs) to differentiate PPG were vertical cup to disc ratio (0.76), inferior quadrant RNFL thickness (0.79), and inferotemporal quadrant GC-IPL thickness (0.73), respectively. Similarly, best LRs were found for clock hour 5, 6, and 12 thicknesses among RNFL; inferior sector and inferotemporal sector thicknesses among GC-IPL parameters. Conclusion: Diagnostic abilities of GC-IPL parameters were comparable to RNFL parameters in differentiating PPG patients from normals. The likelihood of ruling in a disease was greater with GC-IPL parameters.
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Affiliation(s)
| | - Richa Gupta
- Department of Glaucoma, Sarakshi Netralaya, Nagpur, Maharashtra, India
| | | | - Dhananjay Raje
- Department of Data Analysis, MDS Bioanalytics, Nagpur, Maharashtra, India
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Kim SY, Yoon MH, Chin HS. Changes in the Ganglion Cell-inner Plexiform Layer after Consecutive Intravitreal Injections of Anti-vascular Endothelial Growth Factor in Age-related Macular Degeneration Patients. Korean J Ophthalmol 2021; 34:11-18. [PMID: 32037745 PMCID: PMC7010477 DOI: 10.3341/kjo.2019.0081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/06/2019] [Accepted: 09/11/2019] [Indexed: 01/10/2023] Open
Abstract
Purpose To investigate the effect of intravitreal anti-vascular endothelial growth factor (VEGF) injections on ganglion cell-inner plexiform layer (GCIPL) thickness in patients with age-related macular degeneration (AMD). Methods This retrospective study included patients with continuous anti-VEGF treatment who were administered at least three consecutive injections for unilateral neovascular AMD. The GCIPL thickness of the study eyes was compared before and after treatment and with healthy fellow eyes using spectral-domain optical coherence tomography. We also evaluated best-corrected visual acuity, age, and intraocular pressure. Results In total, 96 eyes of 48 patients (14 females and 34 males; mean ± standard deviation [SD] age, 70.10 ± 8.89 years) with mean number of 6.29 (SD ± 3.76) anti-VEGF injections and a mean follow-up period of 24.93 months (SD ± 19.86) were included in the study. After three consecutive intravitreal injections of anti-VEGF, the mean GCIPL thickness was significantly reduced from 70.50 (SD ± 14.06) to 65.97 (SD ± 13.91) µm. Borderline or nonsignificant decrease was also observed in GCIPL thickness for each sector. At the end of the study, the mean GCIPL thickness was further reduced to 62.56 (SD ± 16.30) µm, and significant decreases were also observed in all other sectors compared with baseline. Conclusions It has been observed that GCIPL thickness can decrease with only three consecutive anti-VEGF injections as well as with long-term treatment in AMD patients.
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Affiliation(s)
- Se Young Kim
- Department of Ophthalmology and Inha Vision Science Laboratory, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Myung Hun Yoon
- Department of Ophthalmology and Inha Vision Science Laboratory, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hee Seung Chin
- Department of Ophthalmology and Inha Vision Science Laboratory, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
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Hu H, Li P, Yu X, Wei W, He H, Zhang X. Associations of Ganglion Cell-Inner Plexiform Layer and Optic Nerve Head Parameters with Visual Field Sensitivity in Advanced Glaucoma. Ophthalmic Res 2020; 64:310-320. [PMID: 32731219 DOI: 10.1159/000510572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the associations of optical coherence tomography (OCT)-derived macular ganglion cell-inner plexiform layer thickness (mGCIPLT), circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and optic nerve head (ONH) parameters with visual field (VF) sensitivity in advanced glaucoma. METHODS In this cross-sectional study, 102 eyes from 102 patients with advanced glaucoma (defined as a 24-2 VF mean deviation (MD) of ≤-12 dB) were included. mGCIPLT, cpRNFLT, and ONH parameters (including the rim area, average cup-to-disc [C:D] ratio, and vertical C:D ratio) were measured using Cirrus high-definition OCT, and 24-2 and 10-2 VF sensitivity tests were performed using standard automated perimetry. Pearson correlations and linear models were used to analyze relationships between OCT-derived parameters and VF parameters. RESULTS The mGCIPLT and rim area were significantly positively correlated with the 24-2 VF MD, 24-2 VF pattern standard deviation, 24-2 VF visual field index, and 10-2 VF MD, but cpRNFLT was not significantly correlated with VF parameters. In addition, the average and vertical C:D ratios were significantly negatively correlated with VF parameters. The mGCIPLT and rim area were significantly positively correlated with the 10-2 VF MD (r ranging between 0.542 and 0.621, p < 0.001), while the average and vertical C:D ratios were significantly negatively correlated with the 10-2 VF MD (r = -0.537, p < 0.001, and r = -0.428, p < 0.001, respectively). Each 1-µm change in the average mGCIPLT was associated with an approximately 0.368-dB change in the 24-2 VF MD and 0.677-dB change in the 10-2 VF MD (R2 = 0.268, p < 0.001, and R2 = 0.385, p < 0.001, respectively). The 10-2 VF MD showed a significantly stronger association with inferonasal mGCIPLT than did the 24-2 VF MD in advanced glaucoma (p = 0.007). CONCLUSIONS mGCIPLT and ONH parameters were associated with the severity of VF damage and reflected functional damage better than cpRNFLT in advanced glaucoma. Our results suggested that structural measurements of mGCIPLT and ONH parameters and functional measurement of the 10-2 VF may be useful for monitoring progression in advanced glaucoma.
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Affiliation(s)
- Haijian Hu
- Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Ping Li
- Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Xueqing Yu
- Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Wei Wei
- Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Hai He
- Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Xu Zhang
- Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Research Institute of Ophthalmology and Visual Science, Affiliated Eye Hospital of Nanchang University, Nanchang, China,
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Abstract
Purpose of Review To summarize the available literature on retinal imaging metrics in the context of intravitreal injections in glaucomatous and non-glaucomatous eyes. Recent Findings The retinal nerve fiber layer (RNFL) in injected non-glaucomatous eyes appears to thin at a similar rate to uninjected fellow eyes. A total of four studies evaluating RNFL thinning in injected glaucomatous eyes yielded mixed results, with more recent longitudinal investigations suggesting a potential association. The ganglion cell-inner plexiform layer is also being studied as a potential endpoint in both glaucomatous and non-glaucomatous eyes following intravitreal injections.
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Lee WH, Lee M, Lim H, Kim K, Shin Y, Kim J. Longitudinal changes in the thickness of the ganglion cell-inner plexiform layer in patients with hypertension: a 4-year prospective observational study. Acta Ophthalmol 2020; 98:e479-e486. [PMID: 31658412 DOI: 10.1111/aos.14291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/07/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Hypertension (HTN) is expected to accelerate age-related ganglion cell-inner plexiform layer thickness (GC-IPLs) reduction, but there is limited information on the reduction rate of GC-IPLs in HTN patients. We investigate longitudinal changes in the thickness of GC-IPL in patients with HTN. METHODS We performed a prospective, longitudinal and observational study design. Participants were divided into two groups: HTN group (49 eyes) and control group (56 eyes). After the initial visit, GC-IPLs were measured four times at 1-year intervals using spectral-domain optical coherence tomography. The GC-IPL reduction rate was estimated using a linear mixed model and compared between the two groups. Univariate and multivariate generalized linear mixed models were used to identify factors associated with reductions in GC-IPLs over time. RESULTS In a linear mixed model, the GC-IPL reduction rates for the HTN and control groups were -0.64 (p < 0.001) and -0.19 (p < 0.001) μm/year, respectively, and the interaction between group and follow-up duration was significant (p < 0.001). In the HTN group, all sectors exhibited significant reductions over time (all p < 0.001). Results from univariate and multivariate linear mixed model analyses revealed that age and IOP were significantly associated (p = 0.009 and 0.047, respectively) with reductions in GC-IPLs in HTN patients. CONCLUSION Patients with HTN exhibited a significant reduction in GC-IPLs compared to normal subjects. Additionally, age and IOP affected the reduction rate of GC-IPLs in HTN patients. In various ophthalmic diseases, physicians should consider the longitudinal effect of HTN on GC-IPLs.
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Affiliation(s)
- Woo Hyuk Lee
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Republic of Korea
| | - Min‐Woo Lee
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Republic of Korea
- Department of Ophthalmology Konyang University College of Medicine Daejeon Republic of Korea
| | - Hyung‐Bin Lim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Republic of Korea
| | - Kyeung‐Min Kim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Republic of Korea
| | - Yong‐Il Shin
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Republic of Korea
| | - Jung‐Yeul Kim
- Department of Ophthalmology Chungnam National University College of Medicine Daejeon Republic of Korea
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Jung JH, Seo JH, Kang MS, Shin J. Comparison of glaucoma diagnostic ability of ganglion cell-inner plexiform layer according to the range around the fovea. BMC Ophthalmol 2019; 19:270. [PMID: 31888556 PMCID: PMC6937720 DOI: 10.1186/s12886-019-1283-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022] Open
Abstract
Background To compare the glaucoma diagnostic ability of the ganglion cell-inner plexiform layer (GCIPL) thickness depending on the range around the fovea using wide-angle, swept-source optical coherence tomography (SS-OCT). Methods We compared the glaucoma diagnostic utility of GCIPL parameters across multiple regions while centered on the fovea. In a wide-angle scan, the GCIPL for each 1-mm2 grid square of a 12 × 9 mm2 scan resulted in 108 data points. With respect to the range of the GCIPL measurements around the macula, the wide-angle scan images were classified into three zones. Zone 1 was defined as a narrow area; zone 2 was defined as a mid-sized area; and zone 3 was defined as a wide area. We recorded the quadrant GCIPL thickness, average, and minimum quadrant GCIPL within each zone. The areas under the receiver operating characteristic (AUROCs) curves were calculated to evaluate the glaucoma diagnostic utility. Results Sixty-one eyes with glaucoma and 59 normal eyes were assessed. The minimum and average GCIPL measurements in zones 1–3 in eyes with glaucoma were significantly lower than those in normal eyes (P < 0.001). The AUROCs for the minimum and inferotemporal GCIPL in zone 1 and the inferotemporal GCIPL thickness in zone 2 were greater than 0.9 (0.945, 0.931, and 0.918, respectively). Conclusions Wide-angle scanning using SS-OCT will contribute to improvements in the detection of glaucomatous damage. The minimum and inferotemporal GCIPL in zone 1 may be more useful for detecting glaucoma than those in the conventional area.
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Affiliation(s)
- Jae Ho Jung
- Department of Ophthalmology, College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Je Hyun Seo
- Department of Ophthalmology, Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, South Korea
| | - Min Seung Kang
- Department of Ophthalmology, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jonghoon Shin
- Department of Ophthalmology, College of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea. .,Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea. .,Department of Ophthalmology, School of Medicine, Pusan National University Yangsan Hospital, Pusan National University, 20-Geumo-ro, Mulgeum-eup, Yangsan, 50612, South Korea.
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Shin YI, Kim JM, Lee MW, Jo YJ, Kim JY. Characteristics of the Foveal Microvasculature in Asian Patients with Dry Age-Related Macular Degeneration: An Optical Coherence Tomography Angiography Study. Ophthalmologica 2019; 243:145-153. [PMID: 31645037 DOI: 10.1159/000503295] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/09/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate changes in the foveal microvasculature in patients with dry age-related macular degeneration (dry AMD) using optical coherence tomography angiography (OCTA). METHODS Eighty-three eyes with dry AMD and 83 age- and sex-matched normal eyes were enrolled. A 3 × 3 mm2 OCTA (Zeiss HD-OCT 5000 with AngioPlex; Carl Zeiss Meditec, Dublin, CA, USA) scan was used to acquire images. Vessel density (VD), perfusion density (PD), and the foveal avascular zone (FAZ) of the superficial capillary plexus were analyzed. RESULTS The VD of the full area, central area, and inner ring of the dry AMD patients (18.61, 8.41, and 20.45, respectively) were significantly lower than those of the controls (20.06, 11.09, and 22.51, respectively). The PD of the full area, central area, and inner ring of the dry AMD patients (0.34, 0.15, and 0.37, respectively) were also significantly lower than those of the controls (0.36, 0.19, and 0.40, respectively). The FAZ area and perimeter in the dry AMD patients (0.29 mm2 and 2.47 mm, respectively) were larger than those in the controls (0.23 mm2 and 2.09 mm, respectively). The FAZ circularity index in the dry AMD patients was smaller than that in the controls (0.61 vs. 0.66). Using univariate linear regression, age, best-corrected visual acuity (BCVA), central macular thickness (CMT), and ganglion cell-inner plexiform layer (GC-IPL) thickness were associated with both VD and PD of the full area. Using multivariate analysis, only GC-IPL thickness was significantly associated with the VD and PD of the full area (p = 0.001 and p = 0.004, respectively). CONCLUSIONS OCTA revealed changes in the foveal microcirculation of patients with dry AMD. Age, BCVA, CMT, and GC-IPL thickness should be considered when analyzing the OCTA data of patients with dry AMD. GC-IPL thickness is particularly important during clinical evaluation of VD and PD in patients with dry AMD.
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Affiliation(s)
- Yong-Il Shin
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ju Mi Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Min-Woo Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Young-Joon Jo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea,
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Xu X, Guo X, Xiao H, Mi L, Chen X, Liu X. Reproducibility of macular ganglion cell-inner plexiform layer thickness in normal eyes determined by two different OCT scanning protocols. BMC Ophthalmol 2017; 17:37. [PMID: 28376748 PMCID: PMC5379644 DOI: 10.1186/s12886-017-0434-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the reproducibility of macular ganglion cell-inner plexiform layer (GCIPL) thickness measurement in normal eyes determined by different operators and two different raster scanning protocols of Cirrus high-definition optical coherence tomography (HD-OCT). METHODS One hundred and two eyes of 102 normal subjects were scanned three times using Cirrus HD-OCT with Macular Cube 512 × 128 protocol by two operators, respectively. Three extra scans were obtained using Macular Cube 200 × 200 protocol. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness was measured. The reproducibility of the measurements was evaluated with intraclass correlation coefficients (ICC) and coefficients of variation (CoV). RESULTS The intra-operator ICCs of macular GCIPL thickness were >0.875; and the inter-operator ICCs were 0.882 to 0.991. The intra-protocol ICCs of Macular Cube 512 × 128 and 200 × 200 protocol were 0.953 to 0.987 and 0.953 to 0.991, respectively; and the inter-protocol ICCs were 0.876 to 0.991. All CoVs were <1.5%. CONCLUSIONS Cirrus HD-OCT can measure macular GCIPL thickness in normal eyes with excellent reproducibility. The measurements determined by Macular Cube 512 × 128 and 200 × 200 protocol were highly consistent and both protocols were eligible for macular GCIPL thickness measurement.
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Affiliation(s)
- Xiaoyu Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Yuexiu District, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Yuexiu District, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Hui Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Yuexiu District, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Lan Mi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Yuexiu District, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiangxi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Yuexiu District, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 South Xianlie Road, Yuexiu District, Guangzhou, Guangdong, 510060, People's Republic of China.
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