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Takamura Y, Yamada Y, Noda K, Morioka M, Hashimoto Y, Gozawa M, Matsumura T, Inatani M. Characteristic distribution of microaneurysms and capillary dropouts in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2020; 258:1625-1630. [PMID: 32367289 DOI: 10.1007/s00417-020-04722-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/20/2020] [Accepted: 04/25/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To investigate the distribution pattern of microaneurysms (MAs) and capillary dropouts (CDOs) related to retinal thickness in patients with diabetic macular edema (DME). METHODS We designed a cross-sectional observational study in which we manually merged fluorescein angiography and optical coherence tomography (OCT) map and located MAs and CDOs areas. The density of MAs, the width and the length of circumference of CDOs, and the number of MAs adjacent to CDOs were compared between highly thickened (white area (WA) in OCT map) and border areas (red area (RA)). RESULTS We examined 115 eyes of 115 patients with DME. The density of MAs in RA (1.086 ± 0.616) was significantly higher than that in WA (0.8601 ± 1.086) (p = 0.002). The MA rates adjacent to CDOs in WA and RA were 79.1% and 80.7%, respectively. In the RA, the size of CDO adjacent to MAs was smaller (p = 0.013), but its circumference was longer (p = 0.018), and the number of MAs adjacent to CDOs was larger than those in WA (p = 0.002). The total length of circumference of CDOs was significantly correlated with the number of MAs adjacent to CDOs in WA (p = 0.011, R2 = 0.68) and RA (p = 0.008, R2 = 0.81). CONCLUSION Smaller but more CDOs with longer circumference adjacent to MAs contribute to the higher density of MAs in the surrounding areas of DME.
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Affiliation(s)
- Yoshihiro Takamura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, 910-1193, Japan.
| | - Yutaka Yamada
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, 910-1193, Japan
| | - Kosuke Noda
- Department of Ophthalmology, Laboratory of Ocular Cell Biology and Visual Science, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masakazu Morioka
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, 910-1193, Japan
| | - Yuki Hashimoto
- Department of Ophthalmology, Laboratory of Ocular Cell Biology and Visual Science, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Makoto Gozawa
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, 910-1193, Japan
| | - Takehiro Matsumura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, 910-1193, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, 910-1193, Japan
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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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Venkatesh R, Gurav P, Abhishek Dave P, Gandhi A. Capillary Dropout: A Novel Fluorescein Angiography Finding in Primary Vitreoretinal Lymphoma. Ocul Oncol Pathol 2017; 3:324-327. [PMID: 29344490 DOI: 10.1159/000472152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 01/31/2017] [Revised: 03/22/2017] [Indexed: 11/19/2022] Open
Abstract
Tissue diagnosis with vitreous and/or retinal biopsy usually confirms the diagnosis of primary vitreoretinal lymphoma. Multiple imaging modalities like fundus fluorescein angiography, fundus autofluorescence, and optical coherence tomography have been used to support the diagnosis of vitreoretinal lymphoma. We report a case of a 74-year-old lady diagnosed with primary vitreoretinal lymphoma showing a novel fluorescein angiographic finding of capillary dropout. We hypothesize that this clinical finding on the fluorescein angiogram may be due to the occlusion of the retinal vasculature by the malignant tumor cells. This finding also suggests the possible intraocular invasion of the malignant lymphomatous cells into the inner retinal layers.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Uvea, Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | - Prachi Gurav
- Department of Uvea, Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | - Prachi Abhishek Dave
- Department of Uvea, Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | - Arpan Gandhi
- Department of Ocular Pathology, Dr. Shroff's Charity Eye Hospital, Delhi, India
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Tokimitsu M, Murata M, Toriyama Y, Hirano T, Iesato Y, Murata T. Delineation of capillary dropout in the deep retinal capillary plexus using optical coherence tomography angiography in a patient with Purtscher's retinopathy exhibiting normal fluorescein angiography findings: a case report. BMC Ophthalmol 2016; 16:113. [PMID: 27430650 PMCID: PMC4950236 DOI: 10.1186/s12886-016-0298-x] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/13/2016] [Indexed: 11/12/2022] Open
Abstract
Background Fat embolism in the deep retinal capillary plexus is one of the reported mechanisms underlying central/paracentral scotoma in patients with Purtscher’s retinopathy. Here we report the clear delineation of capillary dropout in the deep capillary plexus using optical coherence tomography angiography (OCTA) in a chronic case of unexplained scotoma that developed after femoral fracture. The patient exhibited normal fluorescein angiography (FA) findings and a normal retinal appearance. Case presentation A 42-year-old Japanese man with a history of bilateral, unexplained paracentral scotoma that developed after femoral fracture and pulmonary fat embolism due to a car accident 20 years ago was referred to our outpatient clinic. Initial ophthalmological examination revealed unremarkable retinal findings. Goldmann perimetry, FA, and full field electroretinography showed no pathological changes. Although fat embolism in the retinal vasculature was suspected, psychosomatic visual field defects could not be ruled out. We performed OCTA, which clearly delineated capillary dropout in the deep retinal capillary plexus. A final diagnosis of paracentral acute middle maculopathy secondary to Purtscher’s retinopathy was made on the basis of this finding. Conclusions Our findings suggest that OCTA clearly and noninvasively delineates the deep retinal capillary plexus and the superficial capillary plexus. Because conventional FA provides limited depth resolution, capillary dropout restricted within the deep capillary plexus cannot be detected, particularly when the superficial capillary plexus is well preserved. Thus, OCTA can be a useful tool for the detection of capillary dropout in the deep retinal capillary plexus.
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Affiliation(s)
- Motoharu Tokimitsu
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Masako Murata
- Department of Ophthalmology, Matsumoto Medical Center, National Hospital Organization, Matsumoto, Nagano, Japan
| | - Yuichi Toriyama
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Takao Hirano
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Yasuhiro Iesato
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Toshinori Murata
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
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