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Doğan ME, Erkan Pota Ç. Investigation of the effects of gestational diabetes and hypertension on retinal and choroidal microvascular circulation using swept-source optical coherence tomography angiography. Microvasc Res 2024; 152:104622. [PMID: 37981229 DOI: 10.1016/j.mvr.2023.104622] [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: 08/08/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The aim of this study was to investigate the microvascular changes in the retina and choroid in gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) and to compare the results with those of healthy pregnant subjects. METHODS Twenty-nine pregnant subjects with coexisting GDM and PIH (group 1) and 36 healthy pregnant subjects (group 2) were enrolled in the study. All subjects were examined by optical coherence tomography (OCT) and angiography (OCTA). The retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), choroidal thickness (CT), superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) vascular density (VD), and foveal avascular zone (FAZ) were measured. RESULTS We observed that the values of CT and VD were lower in group 1 than in group 2. No significant difference was found between groups in RT, FAZ area and CC VD. SCP and DCP VD values were higher in group 2 in all quadrants. We observed a significant increase in FAZ area and CC VD with increasing systolic blood pressure. No correlation was observed between diastolic blood pressure and FBS with other parameters. In group 1, FAZ area was significantly higher in the diet-treated group than in the insulin-treated group. CONCLUSION Monitoring and treatment of pregnant women with PIH and GDM is important because of the risks that may occur during pregnancy. We believe that changes in microvascular circulation can be detected noninvasively with OCTA, even in the absence of clinical or retinal findings.
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Affiliation(s)
- Mehmet Erkan Doğan
- Department of Ophthalmology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Çisil Erkan Pota
- Department of Ophthalmology, Manavgat State Hospital, Antalya, Turkey.
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Liu G, Wang F. Macular vascular changes in pregnant women with gestational diabetes mellitus by optical coherence tomography angiography. BMC Ophthalmol 2021; 21:170. [PMID: 33836718 PMCID: PMC8034184 DOI: 10.1186/s12886-021-01927-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/29/2021] [Indexed: 12/05/2022] Open
Abstract
Background Retinal capillary is vulnerable to diabetes, whether gestational diabetes mellitus (GDM) eyes without clinical retinopathy have capillary abnormalities has not been well studied. To observe the microvasculature changes in eyes of GDM women compared with normoglycemic pregnant women and non-pregnant women by optical coherence tomography-angiography (OCT-A). Methods GDM women, age-matched normoglycemic pregnant women and non-pregnant women were included in this study. All subjects were examined by OCT-A, vascular density and macular foveal parameters were measured automatically. Results Thirty eight non-pregnant women (NC group), thirty pregnant women without GDM (PC group), and thirty one GDM women (GDM group) were included in this study. There was a significant reduction of vascular density in superficial capillary layer, but an increase in deep capillary layer in PC and GDM groups (P < 0.001). When in terms of the average vascular density, the difference was insignificant among these three groups. Although all the measurements were similar between PC and GDM groups, more capillary “dropout” changes were detected in GDM group. Unexpectedly, the abnormal changes of central macular thickness thinning and foveal avascular zone enlargement seen during pregnancy were improved when compared to PC group. Conclusions The changes of vascular density implied the redistribution of capillary network from superficial to deep layer under pregnancy and GDM states. Although the transient hyperglycemia aggravates the changes of capillary “dropout”, GDM group revealed the improvement of central macular thickness thinning and foveal avascular zone enlargement during pregnancy.
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Affiliation(s)
- Guodong Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital affiliated with Tongji University, 301 Middle Yan Chang Road, Shanghai, 200072, People's Republic of China
| | - Fang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital affiliated with Tongji University, 301 Middle Yan Chang Road, Shanghai, 200072, People's Republic of China.
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Akmaz B, Akay F, Güven YZ, Kaptan F, Demirdal T. The long-term effect of human immunodeficiency virus infection on retinal microvasculature and the ganglion cell-inner plexiform layer: an OCT angiography study. Graefes Arch Clin Exp Ophthalmol 2020; 258:1671-6. [PMID: 32445017 DOI: 10.1007/s00417-020-04749-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/03/2020] [Accepted: 05/09/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To investigate the long-term effect of HIV infection on the ganglion cell-inner plexiform layer and retinal capillary network. METHODS This prospective, cross-sectional case-control study included 45 HIV-infected patients and 45 healthy individuals. Optical coherence tomography angiography (OCTA) was used for the assessment of macular, peripapillary retinal nerve fiber layer (RNFL) thicknesses, ganglion cell-inner plexiform layer, vessel density, perfusion density, and foveal avascular zone. RESULTS The mean disease duration was 7.3 ± 1.9 years (range, 5-12 years) in the HIV group. The mean CD4 count (nadir) for all the patients was 147.09 ± 122 cells/mm3 and the mean RNA was 173.6 ± 913.8 copies/ml. No statistically significant difference was determined between the groups in respect of the average and foveal MT (p = 0.05). A significant difference was found between the two groups in respect of the mean VD and PD parameters (p < 0.05). Peripapillary PD was significantly decreased in the HIV group. There was a significant difference between the average and superior and inferior half-region of GC-IPL values. Using Pearson's correlation analysis, no significant correlation was determined between the duration of HIV infection and mean GC-IPL, MT and VD, and PD values (r - 0.223, p 0.141; r - 0.223, p 0.141; r - 0.169, p 0.268; r - 0.105, p 0.491; r - 0.095, p 0.535 respectively). CONCLUSIONS The results of this study provide evidence of microvascular and neuroretinal loss in individuals with well-suppressed HIV infection, compared with healthy control subjects. OCTA is an important test for the screening of retinal microvascular changes over time in HIV-infected cases.
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Shen C, Yan S, Du M, Zhao H, Shao L, Hu Y. Assessment of capillary dropout in the superficial retinal capillary plexus by optical coherence tomography angiography in the early stage of diabetic retinopathy. BMC Ophthalmol 2018; 18:113. [PMID: 29739379 PMCID: PMC5941753 DOI: 10.1186/s12886-018-0778-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 10/24/2017] [Accepted: 04/27/2018] [Indexed: 01/29/2023] Open
Abstract
Background To assess capillary dropout in the superficial retinal capillary plexus (SCP) by optical coherence tomography angiography (OCTA) in the early stage of diabetic retinopathy (DR). Methods This study was a cross-sectional observational study. Patients that underwent OCTA examinations in our hospital between November 2015 and May 2016 were included in the study. The subjects were divided into two groups: A) normal controls (41 eyes of 41 subjects) and B) the DR patients (49 eyes of 49 patients with mild non-proliferative DR (NPDR)). The retinal thickness and SCP vessel density were analyzed using built-in software in nine sections of the macular area; whole scan area; fovea; parafovea; and sub-sections of the parafovea, superior-hemi, inferior-hemi, temporal, superior, nasal, and inferior. The correlation between vessel density and retinal thickness was also analyzed. Results The SCP density was significantly lower (P < 0.05) in mild NPDR patients than in normal controls in all areas, with the exception of the fovea (P > 0.05). In the parafovea, superior-hemi, inferior-hemi, temporal, and nasal sectors of group B, the SCP density was negatively correlated with the corresponding retinal thickness (P < 0.05). Specifically, as the SCP density decreased, retinal thickness increased. Conclusions In the early stage of NPDR, retinal capillary dropout and retinal thickness changes can be clearly captured and analyzed by OCTA. The results confirm a negative correlation between vessel density and retinal thickness in diabetic patients. This noninvasive technique could be applied for DR detection and monitoring. Further study with a larger sample size is warranted.
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Affiliation(s)
- Ceying Shen
- Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou Hanghai Middle Road No. 90, Zhengzhou, 450000, China.
| | - Shu Yan
- Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou Hanghai Middle Road No. 90, Zhengzhou, 450000, China
| | - Min Du
- Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou Hanghai Middle Road No. 90, Zhengzhou, 450000, China
| | - Hong Zhao
- Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou Hanghai Middle Road No. 90, Zhengzhou, 450000, China
| | - Ling Shao
- Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou Hanghai Middle Road No. 90, Zhengzhou, 450000, China
| | - Yibo Hu
- Department of Zhengzhou Second People Hospital, Ophthalmology, Zhengzhou Eye Hospital, Zhengzhou Ophthalmic Institution, Zhengzhou Hanghai Middle Road No. 90, Zhengzhou, 450000, China
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Zong Y, Zhou X, Cheng J, Yu J, Wu J, Jiang C. Cannabinoids Regulate the Diameter of Pericyte-Containing Retinal Capillaries in Rats. Cell Physiol Biochem 2017; 43:2088-2101. [PMID: 29059679 DOI: 10.1159/000484193] [Citation(s) in RCA: 11] [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: 02/12/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Cannabinoids are vasoactive substances that act as key regulators of arterial tone in the blood vessels supplying peripheral tissues and the central nervous system. We therefore investigated the effect of cannabinoids on retinal capillaries and pericytes. METHODS The effects of cannabinoids on capillary diameters were determined using an ex vivo whole-mount rat retinal model. Western blotting, quantitative PCR, and immunohistochemistry were performed to explore the underlying mechanism. RESULTS Endogenous cannabinoid 2-arachidonoylglycerol and anandamide and exogenous cannabinoid (R-(+)-WIN55212-2) dilated the noradrenaline-precontracted capillaries in a concentration-dependent manner (1 µM to 0.1 mM). The extent of vasorelaxation was positively correlated with changes in pericyte width. The effects of R-(+)-WIN55212-2 on vasorelaxation and pericyte width were inhibited by a cannabinoid receptor type-1 (CB1) antagonist, AM251 or rimonabant (SR141716A), the nitric oxide synthase inhibitor l-NAME, and the guanylate cyclase inhibitor ODQ. They were also abolished by the removal of the endothelium, but not by the cannabinoid receptor-2 antagonist SR144528, the endothelial cannabinoid receptor antagonist O-1918, or the cyclooxygenase inhibitor indomethacin. CONCLUSION The exogenous cannabinoid R-(+)-WIN55212-2 promotes the vasorelaxation of pericyte-containing rat retinal capillaries. This effect of R-(+)-WIN55212-2 is dependent on CB1 and the nitric oxide-cyclic guanosine monophosphate pathway, and requires an intact endothelium.
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Affiliation(s)
- Yuan Zong
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Xujiao Zhou
- Eye and ENT Hospital, State Key laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Jingyi Cheng
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Jian Yu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Jihong Wu
- Eye and ENT Hospital, State Key laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Chunhui Jiang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.,Department of Ophthalmology, People's Hospital of Shanghai No. 5, Shanghai, China
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