Meta-analysis of retinal microvascular changes in migraine patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore retinal microvascular changes in migraine patients using meta-analysis.METHODS: The National Library of Medicine PubMed, Embase, and Cochrane Library were searched to find relevant studies, and the search period was from the creation of database to June 2023. Two investigators independently screened the literatures, extracted data, and evaluated the quality of included studies using the NOS scale. STATA15.0 was used for Meta-analysis and publication bias evaluation, sensitivity analysis was performed for results with large heterogeneity, and the funnel plot and Egger were used to assess the publication bias of the literature.RESULTS:A total of 12 studies, including 217 patients(252 eyes)with migraine with aura(MA), 283 patients(388 eyes)with migraine without aura(MO), and 374 healthy individuals(479 eyes), were included in this Meta-analysis. Several optical coherence tomography angiography(OCTA)indicators, including foveal avascular zone(FAZ)macular or optic disc perfusion density were compared and analyzed. The Meta-analysis results showed that compared with healthy controls, patients with MA had a significant increase in FAZ area and perimeter, a significant decrease in perfusion density of the macular deep capillary plexus(mDCP)except for the fovea, and a significant decrease in perfusion density of the radial peripapillary capillaries(RPC)around the optic disc; the FAZ parameters were significantly increased in MO, while the differences in perfusion density of the macular superficial capillary plexus(mSCP), mDCP and RPC were not statistically significant, except for the perfusion density in the parafovea mDCP.CONCLUSIONS: Both MA and MO patients had an enlarged FAZ area, patients with MA had a significant decrease in mDCP perfusion density, and migraine patients had some degree of retinal ischemia.

Retinal perfusion density can predict cardiovascular disease risk in patients with retinal vein occlusion

Purpose: To correlate microvascular changes and assess the relationship between microvascular changes and cardiovascular disease (CVD) risk in patients with retinal vein occlusion (RVO). Methods: Patients over 40 years of age with unilateral RVO were included in this prospective study. Those known to have cardiovascular disease were excluded. A detailed medical history was taken and physical exam was done to measure the height, weight, body mass index (BMI), and systolic blood pressure (SBP). A comprehensive eye check?up was followed by optical coherence tomography angiography (OCTA). Microvascular indices such as vessel density (VD) and perfusion density (PD) were noted. A statistical model was developed for prediction of CVD risk and was integrated with the World Health Organization (WHO)’s risk prediction charts. Results: This study included 42 patients with RVO and 22 controls with an age range of 42–82 years. There were 40 males (62.5%) and 24 females (37.5%). Along with age, SBP, and gender, perfusion density was found to have significant impact on CVD risk (P = 0.030). Reduction in PD was associated with increase in CVD risk. PD had a greater influence on CVD in <50 years age than in >70 years group. Using linear regression, a model with accuracy of 72.1% was developed for CVD risk prediction and was converted into color coded charts similar to WHO risk prediction charts. Conclusion: These findings suggest a significant correlation between microvascular parameters and CVD risk in RVO patients. Based on these parameters, an easy?to?use and color?coded risk prediction chart was developed

Study on the correlation between tear film lipid layer thickness and macular microvascular changes in patients with diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the correlation between tear film lipid layer thickness(LLT)and macular microvascular parameters in diabetic retinopathy. <p>METHODS: Totally 60 eyes of type 2 diabetes patients with non-proliferative stage(NPDR group)and 60 eyes of proliferative stage(PDR group)with diabetic retinopathy diagnosed in our hospital from 2018-01/12 were selected, and 60 eyes of healthy volunteers with appropriate age and gender were selected as the normal control group. The tear film lipid layer thickness(LLT)was examined by Lipiview eye surface interferometer, while the foveal avascular zone(FAZ), superficial capillary layer(SCL)vessel density and deep capillary layer(DCL)vessel density were measured by optical coherence tomography angiography(OCTA)in three groups. The differences and correlations between the parameters were compared. <p>RESULTS: LLT(69.87±11.401nm)in normal control group was higher than that in NPDR(54.87±7.453nm)and PDR group(42.67±5.246nm), and FAZ(0.312±0.021mm2)was lower than that in NDPR group(0.389±0.037mm2)and PDR group(0.437±0.032mm2). The vascular density of SCL(51.977%±4.164%)was significantly higher than that of NPDR(47.067%±4.757%)and PDR(41.865%±5.512%), and that of DCL(49.578%±2.619%)was higher than that of NPDR(46.032%±2.622%)and PDR(40.598%±2.671%)(all <i>P</i><0.01). There was no correlation between LLT, FAZ, SCL and DCL in normal subjects. LLT was negatively correlated with FAZ in both NPDR group and PDR group(<i>r</i>=-0.922, <i>r</i>=-0.923, all <i>P</i><0.01), positively correlated with SCL(<i>r</i>=0.798, <i>r</i>=0.902, all <i>P</i><0.01), and had no correlation with DCL(<i>r</i>=0.140, <i>r</i>=0.073, <i>P</i>=0.285, <i>P</i>=0.581).<p>CONCLUSION: In diabetic retinopathy, the lipid layer of tear film is lower and the stability of tear film is decreased, and there is a correlation between diabetic dry eye and macular microvascular changes.

Foveal Microvascular Changes Based on Optical Coherence Tomography Angiography in Mild Nonproliferative Diabetic Retinopathy

PURPOSE: To investigate the microvascular change in diabetic patients with no diabetic retinopathy (DR) and mild nonproliferative DR (NPDR) using optical coherence tomography angiography (OCTA). METHODS: We retrospectively reviewed the medical records of 44 eyes of 22 patients with no DR and 34 eyes of 17 patients with mild NPDR. OCTA was performed on a 3 × 3 mm region centered in the fovea and parafoveal areas. The foveal avascular zone (FAZ) and foveal and parafoveal flow density (FD) in superficial and deep vascular plexuses were analyzed using OCTA. RESULTS: The FAZ of deep capillary plexus in patients with mild NPDR was significantly larger than in patients with no DR (p = 0.008). The parafoveal deep FD, foveal and parafoveal thickness in patients with no DR was significantly larger than in patients with mild NPDR (p = 0.013, p = 0.018 and p = 0.003, respectively). Superficial FAZ, superficial foveal FD, superficial parafoveal FD and deep foveal FD were not significantly different between the patients with no DR and those with mild NPDR. CONCLUSIONS: OCTA allows detection of deep FAZ enlargement, reduction in parafoveal deep FD as well as foveal and parafoveal thickness in patients with mild NPDR compared with patients with no DR.

Clinical reference value of retinal microvascular changes in patients with cerebral microbleeds / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds ( CMBs) and discuss its clinical significance. METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76. 3 ± 11. 2 years old. For all patients, functions of liver and kidney, blood - lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent ( RAE) , retinal venular equivalent ( RVE) , retinal vein diameter ratio ( AVR) and arteriovenous crossing sign ( AVN ) were identified, CMBs were classified with cerebral MRl. All the data were processed by SPSS statistical software. RESULTS: The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and AVR values in the eyes were found no statistical difference (P COCLUSlON: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.

Perspectivas en el estudio del fenómeno de Raynaud desde un punto de vista ecográfico / Perspectives of ultrasound in the assessment of Raynaud's phenomenon

Un correcto estudio de las alteraciones morfovasculares es un constante reto para el reumatólogo. Entre las manifestaciones clínicas más importantes para este fin, se encuentra el fenómeno de Raynaud en sus diferentes formas de presentación. La ecografía dinámica, mediante la modalidad del Doppler color y el Doppler de poder, encuentra cada vez mayores aplicaciones. El poder determinar la fase de actividad y severidad de la enfermedad vascular, contar con un dato predictivo de evolución del fenómeno de Raynaud y poder monitorear la respuesta al tratamiento son elementos en los cuales la ecografía ha generado últimamente una buena cantidad de datos que están despertando un gran interés por parte del reumatólogo. Esta revisión intenta abordar el concepto acerca de la utilidad de la ecografía en el estudio del fenómeno de Raynaud, haciendo un particular énfasis en sus potenciales y ventajas.

An adequate assessment of the microvascular changes is a continuous challenge for the rheumatologist. Raynaud’s phenomenon is the major clinical expression of this pathological condition. Dynamic ultrasound, using color Doppler or power Doppler systems, is generating a great interest by rheumatologist for its several potentialities. The possibility to determine the disease activity and severity, its potential in the predictive value and the capability of treatment monitoring are essential elements when the US is now firmly established. This paper was designed to give an up-to-date about the utility of US in the assessment of Raynaud’s phenomenon, with particular interest on its potentials and advantages.

A Scanning Electron Microscopic Study on Microvascular Changes in the Monocrotaline-induced Rat Lung by Corrosion Casting Method

To investigate the microvascular changes in primary pulmonary hypertension, the lungs of 24 Sprague-Dawley rats were treated by an intraperitoneal injection of 2% monocrotaline(MCT) solution and then examined with scanning electron microscopy(SEM) after microvascular corrosion casting. Histologic examination revealed significant medial thickening in the small to medium-sized pulmonary arteries. Scanning electron microscopic findings of the normal lungs showed two kinds of microvascular structures. One showed a well-fortned three-dimensional basket structure of uniform flat-tubular alveolar capillaries, which were connected to each other in a T or Y shape or at right angles. The other revealed a two-dimensional reticular sheet of round tubular branches mainly in the bronchial artery-supplying regions. The MCT-treated groups(remodelling) showed apparent changes in both kinds of microvasculatures in comparison to the normal group but the more prominent change was found in Lbe bronchial artery microvasculature showing the dense thick encasement around large pulmonary arteries. Alveolar microvasculature of the pulmonary artery revealed individually enlarged angular appearance, with generally deformed alveolar architecture. Quantitatively, the significant enlargement of diameter and intercapillary distance appeared in both microvasculatures of MCT-induced rat lungs, but the density was increased only in the bronchial artery microvasculature. In conclusion, our three-dimensional microvascular study of the MCT-treated rat lungs demonstrates a new morphologic finding of vascular remodeling in primary puhnonary hypertension, which is thought to play an important vascular role in the pathogenesis in addition to interstitial fibrosis.