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AIM: To observe the changes of macular retinal structure and microcirculation in patients with pituitary adenoma(PA)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA).METHODS: Cross-sectional study. A total of 40 PA patients treated at the department of neurosurgery, Affiliated Hospital of Guangdong Medical University from September 2021 to March 2023 were included as PA group, and 42 age- and gender-matched healthy volunteers were selected as normal control group. All patients underwent visual field, OCT and OCTA examinations, and the correlation of ocular parameters in PA patients was analyzed.RESULTS:The vessel density(VD)of each retinal layer in the macular area of the PA group was lower than that of the normal control group, and the superficial vascular complex(SVC)-VD in the macular area was positively correlated with the thickness of the macular ganglion cell complex(mGCC)(except the nasal side of the inner ring and the lower part of the outer ring; P<0.05). The thickness of mGCC in each quadrant of the macular area and the thickness of the circumpapillary retinal nerve fiber layer(CP-RNFL)in each quadrant were negatively correlated with the mean defect(MD)value of the visual field(P<0.05), and the area of the foveal avascular zone(FAZ)was positively correlated with the MD value(P<0.05).CONCLUSION:The combination of OCT and OCTA can fully understand the microscopic changes of retinal structure and microcirculation function in PA patients, which is of great value in evaluating the preoperative visual function of PA patients.
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Objective: To evaluate the effect of uncomplicated cataract surgery on macular and optic nerve head blood flow with Optical Coherence Tomography Angiography (OCT-A). Retinal vascular changes and macular vessel remodeling following cataract surgery is an area of interest, as the effect, cause and duration of such changes remain debatable.Setting: Eye Department, Red Cross Tertiary General Hospital, Athens, Greece.Methods: In this study, we recruited cataract surgery candidates who had regular post operative visits and underwent longitudinal OCT-A examinations before and after surgery.Results: Macular vessel density increased in the post operative visits both in the superficial (SCP) and deep capillary network (DCP) (P<0.001) and showed a persistent effect over 3 months follow-up. Macular thickness increased over the first postoperative month, but returned to preoperative values at 3 months. Foveal avascular zone (FAZ) measurements and vessel density at radial peripapillary capillaries (RPC) were unaffected.Conclusions: OCT-A enables a quantitative analysis of blood flow by regular patient monitoring. In this study, we found that after cataract surgery, macular blood flow increased significantly. The reason for this could be attributed to post operative inflammatory process or vascular remodeling due to change in retinal metabolic demands.
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Purpose: The primary objective of the study was to assess the macular retinal vessel density, subfoveal choroidal thickness, and retinal layer metrics by optical coherence tomography angiography (OCTA), enhanced?depth imaging optical coherence tomography (EDI?OCT), and spectral domain optical coherence tomography (SD?OCT), respectively, in recovered COVID?19 patients and its comparison with the same in control subjects. The secondary objective was to evaluate differences in OCTA parameters in relation with the severity of COVID?19 disease and administration of corticosteroids. Methods: A case–control study was performed that included patients who had recovered from COVID?19 and age?matched healthy controls. Complete ocular examination including OCTA, SD?OCT, and EDI?OCT were performed three months following the diagnosis. Results: Three hundred sixty eyes of 180 subjects were enrolled between the two groups. A decreased mean foveal avascular zone area in both superficial capillary plexuses (P = 0.03) and deep capillary plexuses (P < 0.01), reduced average ganglion cell layer?inner plexiform layer thickness (P = 0.04), and increased subfoveal choroidal thickness (P < 0.001) were observed among cases in comparison to the control group. A significant correlation was found between sectoral macular vessel density in relation to disease severity and a decrease in vessel density with greater severity of the disease. Conclusion: OCTA detected retinal microvascular alterations following SARS?CoV?2 infection in subjects with the absence of any clinical ocular manifestation or systemic thrombotic events. These parameters could be used to help identify patients with a higher incidence of systemic thromboembolism on longer follow?ups and identify the impact of corticosteroids on retinal architecture.
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AIM:To observe the changes of macular morphology and microcirculation in myopic maculopathy(MM), and investigate theirs correlation and effects on vision.METHODS: Case-control study. A total of 165 patients(189 eyes)with high myopia and 154 healthy volunteers(154 eyes)from October 2016 to December 2018 were selected. According to the classification of Meta-analysis for pathologic myopia(META-PM), participants were divided into M0 group(category 0, 41 eyes), M1 group(category 1, 53 eyes), M2 group(category 2 and 3, 52 eyes), and myopic choroidal neovascularization(mCNV)group(43 eyes). All participants underwent optical coherence tomography angiography(OCTA)examination. Morphological and microcirculation parameters of retina at different layers were compared between groups. Pearson correlation was used to assess the correlation between morphological and microcirculation parameters. Correlations between vision and other parameters were analyzed using multiple linear regression analysis.RESULTS:Foveal full retinal thickness(FRT)and outer retinal thickness(ORT)were all lower in M0, M1 and M2 groups than those of control group(all P<0.01). Foveal superficial capillary plexus vessel density(SVD)and deep capillary plexus vessel density(DVD)were all lower in M2 and mCNV groups than those of the control group(all P<0.01). Parafoveal FRT and ORT were all lower in M0, M1, M2 and mCNV groups than those of the control group(all P<0.01). Parafoveal inner retinal thickness(IRT), SVD and DVD were all lower in M2 and mCNV groups than those of the control group(all P<0.01). Subfoveal choroidal thickness(SFCT)and choroid capillaries vessel density(CVD)were all lower in M0, M1, M2 and mCNV groups than those of the control group(all P<0.01). Foveal vessel density of retina and choroid were positively correlated with its thickness in patients with MM without CNV(all P<0.05). Multivariate analysis showed that axial length(AL), diffuse or patchy chorioretinal atrophy were influencing foctors of best corrected visual acuity(BCVA; all P<0.01).CONCLUSION:Retinal morphological changes precede microcirculation changes in MM. Most of all, ORT changes precede IRT changes. Foveal vessel density of retina and choroid were positively correlated with its thickness. The main influencing factors of BCVA were AL and types of MM.
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Objective:To observe and analyze the macular microvascular system changes in unilateral pediatric uveitis (PU) and healthy contralateral eyes.Methods:A cross-sectional case-control study. From January 2019 to July 2021, 21 eyes of 21 patients with PU diagnosed in one eye (PU group), 21 unaffected contralateral eyes (contralateral eye group), and 21 age-matched volunteers with 21 eyes (NC group) during the same period were examined in Peking Union Medical College Hospital. Optical coherence tomography angiography was used to scan the 6 mm × 6 mm fundus macular area in the three groups of selected eyes to measure the vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the retina, the area of the avascular zone (FAZ) in the fovea of the macula, the choroidal thickness under the fovea (SFCT), and the retinal thickness in the fovea of the macula (CRT). The device comes with a software choriocapillary flow measurement tool, which can obtain the macula's choriocapillary density (CCD) with the fovea as the center and the diameter of the annular area of 1.0 mm, 1.5 mm, and 3.0 mm, respectively. They were recorded as CCD-1.0, CCD-1.5, and CCD-3.0. The measurement data of multiple groups were compared by analysis of variance; if the variance of the three groups of data was not uniform, the Kruskal-Wallis test was used. Multiple linear regression analysis was used to evaluate the potentially related factors of CCD.Results:Compared with the contralateral eye group and the NC group, the vessel density of SCP ( H=-13.857,-25.500; P=0.043, P<0.001), DCP ( H=-15.333, -31.595; P=0.007, P<0.001) and CCD-1.0 ( H=-14.000,-16.214; P=0.040, 0.012) of the clinically quiescent PU group were significantly decreased. CRT and FAZ were not statistically different between PU and NC groups ( F=0.955; P=1.000, 0.661). Compared with the NC group, the mean vessel density of SCP and DCP in the contralateral eye group decreased, and the difference in DCP vessel density was statistically significant ( H=-16.262, P=0.004). There was no statistically significant difference between the CCD of two groups ( P=1.000). The SFCT of the PU group was significantly thicker than that of the NC group ( F=5.552, P=0.004), however, difference was not statistically significant from the fellow eye group ( F=5.552, P=0.270). The results of multiple linear regression analysis revealed that the CCD-1.0, CCD-1.5, and CCD-3.0 showed a linear correlation with the area of FAZ ( β=-0.494, -0.527, -0.566; P=0.015, 0.009, 0.010) and CRT ( β=-0.322, -0.466, -0.342; P=0.026, 0.002, 0.028). CCD-1.0 and CCD-1.5 showed a linear correlation with the vessel density of DCP ( β=0.277, 0.275; P=0.047, 0.045). Conclusion:Both retinal and choroidal microvasculature are abnormal in resting eyes with PU, and macular circulation disorders may be present in the unaffected fellow eye.
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AIM: To observe changes in fundus microcirculation of myopic adolescents after wearing orthokeratology by applying optical coherence tomography angiography(OCTA).METHODS: Prospective study. A total of 40 cases(40 eyes)of adolescents with low to moderate myopia who chose orthokeratology to correct visual acuity at our hospital from April 2021 to June 2022 were collected. The uncorrected distant visual acuity and axial length were evaluated at 1, 3 and 6mo before and after wearing orthokeratology, respectively. Furthermore, the changes in superficial vessel density(SVD), deep vessel density(DVD), central retinal thickness(CRT), foveal avascular zone area(FAZ-A), foveal avascular zone perimeter(FAZ-P), retinal nerve fiber layer(RNFL)thickness and radial peripapillary capillaries density(RPCD)were observed by applying OCTA.RESULTS: The uncorrected distant visual acuity was significantly improved at 1, 3 and 6mo after wearing orthokeratology(P<0.001). There was no statistically significant difference in axial length before and after wearing orthokeratology(P>0.05). Moreover, there were significant differences in both SVD of fovea quadrant and DVD of fovea and lower quadrant(P<0.01), but there were no differences in CRT, FAZ-A and FAZ-P, RNFL thickness and RPCD(P>0.05).CONCLUSION: Wearing orthokeratology can significantly improve visual acuity and increase local retinal vessel density in the macula in adolescents with low to moderate myopia.
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AIM: To explore the feasibility of swept source optical coherence tomography angiography(SS-OCTA)in evaluating early retinal and choroidal microcirculation changes in patients with hypertension.METHODS:Prospective clinical study. A total of 27 patients with grade 2 or 3 essential hypertension(hypertension group)diagnosed in the Department of Cardiology of Xi'an First Hospital from July to November 2022 were included in the study. There were 14 males and 13 females. The mean age was(57.11±3.36)years. During the same period, 27 age- and sex-matched normal people without a history of hypertension were selected as the control group, including 12 males and 15 females. The average age was(55.74±2.95)years old. All patients underwent BCVA(LogMAR), intraocular pressure, axial length, slit lamp examination, fundus color photography and SS-OCTA examination. SS-OCTA was used to scan the macular area of the right eye in the range of 6×6 mm. The retina and choroid were divided into three concentric circles with diameters of 0-1 mm, 1-3 mm and 3-6 mm around the fovea according to ETDRS. Macular vessel density(VD), perfusion area(PA), retinal thickness(CMT), choroidal thickness(CT), choroidal vessel volume(CVV)and choroidal vasculr index(CVI)of the superficial capillary plexus(SCP)and the deep capillary plexus(DCP)in the macular area of 0-1 mm, 1-3 mm and 3-6 mm were analyzed and recorded. The changes in VD, PA, CMT, CT, CVV and CVI were compared between the two groups. Independent sample t-test was used to compare VD, PA, CMT and CVI between the two groups; CT, CVV and LogMAR visual acuity were analyzed by Wilcoxon signed rank test of independent samples.RESULTS:Compared with the control group, the hypertensive group had significantly lower VD in the macular area 0-3 mm(0-1 mm, t=-3.144; 1-3 mm, t=-3.611, P<0.05). VD in the area of 3-6 mm showed a tendency to increase compared with the control group(t=1.715, P>0.05). The CMT in the 0-1mm area of the macular area in the hypertension group was lower than that in the control group(t=-2.624, P<0.05). There was no significant difference in CT, CVV and CVI between the two groups(P>0.05).CONCLUSION:The VD of DCP in the 0-3 mm area and the CMT in the 0-1 mm area are decreased in hypertensive patients. There were no significant differences in CT, CVV and CVI between the two groups. VD and CMT in macular DCP may be used as indicators to evaluate the early changes of retinal and choroidal microcirculation in hypertensive patients.
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ABSTRACT Purpose: To investigate inter-eye retinal vessel density and thickness asymmetry in unilateral pseudoexfoliation syndrome and understand its use for the early detection of glaucoma. Methods: Thirty patients with unilateral pseudoexfoliation syndrome were enrolled in our study. Optical coherence tomography angiography macular scans were used measure the retinal vessel density, and optical coherence tomography scans were used to assess the thickness parameters of the peripapillary retinal nerve fiber layer and the macular ganglion cell complex. Inter-eye asymmetry was determined by taking the absolute value of the difference in the vessel density and thickness parameters between the pseudoexfoliation syndrome eye and fellow eye. Results: The mean patient age was 64.20 ± 7.05 y in the study group. Inter-eye asymmetry in the peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex measurements were significant in the study group (p=0.03 and p=0.001, respectively). The vessel density of the macular superficial inner region was significantly lower in eyes with pseudoexfoliation syndrome than in fellow eyes (p=0.035). However, there was no inter-eye asymmetry in the central and full region macular superficial vessel density of eyes with pseudoexfoliation syndrome and fellow eyes (p>0.05). Conclusion: Retinal vessel density can be evaluated using optical coherence tomography angiography measurements. There was inter-eye asymmetry in the inner region macular superficial vessel density, peripapillary retinal nerve fiber layer, and macular ganglion cell complex thickness of the unilateral pseudoexfoliation syndrome eyes and fellow eyes. Further studies on a larger number of subjects might provide more clarity regarding the relationship between the inter-eye asymmetry of the retinal vessel density and thickness parameters with early detection of glaucomatous damage.
RESUMO Objetivo: Investigar a densidade dos vasos interoculares da retina e assimetria na espessura na síndrome de pseudoexfoliação unilateral e o seu uso para a detecção precoce de glaucoma. Métodos: Trinta pacientes com síndrome de pseudoexfoliação unilateral foram incluídos no estudo. As varreduras maculares de angiografia por tomografia de coerência óptica mediram a densidade dos vasos da retina, e as varreduras por tomografia de coerência óptica obtiveram parâmetros de espessura da camada de fibras nervosas da retina peripapilar e do complexo macular de célula ganglionar. A assimetria interocular foi determinada tomando o valor absoluto da diferença entre o olho da síndrome de pseudoexfoliação e o olho oposto nos parâmetros de densidade e espessura dos vasos. Resultados: A média de idade foi 64,20 ± 7,05 anos no grupo de estudo. A assimetria interocular na espessura da camada de fibra nervosa da retina peripapilar e as medidas do complexo macular de célula ganglionar foram estatisticamente significativas no grupo de estudo (p=0,03 e p=0,001, respectivamente). Para os olhos com síndrome de pseudoexfoliação, a densidade do vaso da região macular superficial interna foi significativamente menor do que em olhos opostos (p=0,035). No entanto, não houve assimetria interocular estatisticamente significativa na densidade macular dos vasos superficiais da região central e completa entre os olhos da síndrome de pseudoexfoliação e os olhos opostos (p>0,05). Conclusões: A densidade dos vasos da retina pode ser avaliada por medidas de angiografia por tomografia de coerência óptica. Houve assimetria interocular na densidade macular do vaso superficial da região interna, camada de fibra nervosa da retina peripapilar e espessura do complexo macular de célula ganglionar entre olhos com síndrome de pseudoexfoliação unilateral e olhos opostos. Novos estudos com um número maior de indivíduos podem fornecer a relação entre a assimetria interocular da densidade do vaso da retina e os parâmetros de espessura com detecção precoce de dano glaucomatoso.
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Introduction: Tumors like Odontogenic Keratocyst (OKC), Dentigerous Cyst (DC)and Pyogenic Granuloma are frequently oc- curring in the oral cavity with each of them having relation to angiogenesis. Higher angiogenesis may be associated with increased tissue metabolism, more aggressive biologic behaviour, and increased recurrence and growth rate. Tumor growth is dependent not only on a rise in the number of blood vessels, but also on factors such as protein molecules produced in en- dothelial cells. Microvessel density (MVD), Microvessel area (MVA), Microvessel perimeter (MVP) can predict the growth of the tumour, metastasis and patient’s survival and this value is related to the aggressiveness of the tumour. Aims: The aim of the present study was to determine the angiogenic potential of OKC and DCcompared with normal mucosa using CD 105 marker immunohistochemically. Materials and methods: Immunohistochemical staining was done on 70 paraffin embedded tissue samples. Histopathologi- cally diagnosed cases of OKC, DC and Pyogenic granuloma and healthy gingival tissue samples were retrieved for the study purpose. Results: There was no statistically significant difference in the mean MVD, MVA, MVP values of OKC, DC and pyogenic granu- loma groups. Conclusion: The angiogenic potential was determined in 3 different cases of OKC, Dentigerous Cyst and Pyogenic granuloma in terms of MVD, MVA and MVP and compared to normal mucosa using CD105 marker immunohistochemically.Though the mean values of MVA, MVD, MVP were statistically not significant but was estimated to be higher than the normal mucosa
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Purpose: To assess the macular vessel density (VD) on optical coherence tomography angiography (OCT?A) using proprietary software (automated) and image processing software (manual) in diabetic patients. Methods: In a retrospective study, OCT?A images (Triton, TOPCON Inc.) of type 2 diabetics presenting to a tertiary eye care center in North India between January 2018 and December 2019 with or without nonproliferative diabetic retinopathy (NPDR) and with no macular edema were analyzed. Macular images of size 3 × 3 mm were binarized with global thresholding algorithms (ImageJ software). Outcome measures were superficial capillary plexus VD (SCP?VD, automated and manual), deep capillary plexus VD (DCP?VD, manual), and correlation between automated and manual SCP?VD. Results: OCT?A images of 89 eyes (55 patients) were analyzed: no diabetic retinopathy (NoDR): 29 eyes, mild NPDR: 29 eyes, and moderate NPDR: 31 eyes. Automated SCP?VD did not differ between NoDR and mild NPDR (P = 0.69), but differed between NoDR and moderate NPDR (P = 0.014) and between mild and moderate NPDR (P = 0.033). Manual SCP?VD (Huang and Otsu methods) did not differ between the groups. Manual DCP?VD differed between NoDR and mild NPDR and between NoDR and moderate NPDR, but not between mild and moderate NPDR with both Huang (P = 0.024, 0.003, and 0.51, respectively) and Otsu (P = 0.021, 0.006, and 0.43, respectively) methods. Automated SCP?VD correlated moderately with manual SCP?VD using Huang method (r = 0.51, P < 0.001) with a mean difference of ?0.01% (agreement limits from ?6.60% to +6.57%). Conclusion: DCP?VD differs consistently between NoDR and NPDR with image processing, while SCP?VD shows variable results. Different thresholding algorithms provide different results, and there is a need to establish consensus on the most suited algorithm
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Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID?19 during the second wave of the pandemic in North India. Methods: In this observational cross?sectional study, 70 eyes of 35 patients who recovered from severe COVID?19 during the second wave underwent detailed ophthalmic evaluation 4–6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell?inner plexiform layer (GC?IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID?19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature
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Purpose: To observe the effects of caffeine intake on vessel densities in macular and peripapillary regions and to analyze the correlations of vascular properties of these two interlinked regions in healthy volunteers using optical coherence tomography angiography (OCTA). Methods: In this prospective randomized, double?masked, placebo?controlled study, 120 participants were grouped into two groups: sixty subjects as a study group, which received caffeine and sixty subjects as a placebo group, which received a placebo. OCTA imaging was performed at baseline and 1 h after drug intake. Changes in macular and radial peripapillary capillary (RPC) vessel densities (VD) and foveal avascular zone (FAZ) parameters and correlation of these parameters were analyzed. Results: Baseline macular and RPC VD and FAZ parameters showed no significant difference between study and placebo groups (P > 0.05 for all). VD parameters in all segments of superficial and deep macular regions and peripapillary region showed a statistically significant decrease after caffeine intake (P < 0.001 for all). All macular superficial VD parameters showed a positive correlation with deep perifovea VD (P < 0.05 for all). Also, superficial perifovea VD was positively correlated with all deep macular VD parameters except deep fovea VD (P < 0.05 for all). Conclusion: We show that caffeine causes a decrease in macular and peripapillary vessel densities in healthy subjects, and correlations were observed between macular and peripapillary VD parameters. We believe that future studies are needed to support the effect of caffeine on peripapillary VD and the idea of using deep perifovea VD as the main parameter to estimate superficial macular parameters.
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Purpose: To investigate the retinal and choroidal microcirculation changes in celiac disease (CD) patients via optical coherence tomography angiography (OCT?A). Methods: This cross?sectional study included 44 pediatric patients with newly diagnosed CD and 44 healthy pediatric subjects. The vascular densities (VD) of the superficial, deep, and choriocapillar plexuses (VDs, VDd, and VDcc, respectively) (%), the superficial and deep foveal avascular zones (FAZs and FAZd) (%), the central macular thickness (CMT) (?m), and the subfoveal choroidal thickness (SFCT) (?m) were measured with swept?source OCT?A in addition to a complete ophthalmological examination. Results: Mean ages of the CD patients and the healthy participants were 12.02 ± 2.9 and 13.6 ± 2.3 years, respectively. The central sectors of the VDs and VDd measurements were found to be significantly higher in the study group compared to the control group (p = 0.006; P = 0.001, respectively), and the temporal and nasal values of the VDcc measurements were significantly lower in the study group than in the control group (p ? 0.05 for both values). CMT and FAZ metrics did not differ between the groups (p ? 0.05). SFCT was significantly reduced (p = 0.001), and choroidal thinning was more considerable in female CD patients (p = 0.045). Conclusion: CD seems to affect macular and choroidal microcirculation. The reduced choriocapillaris plexus parameters and choroidal thickness may provide disease activity information.
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@#AIM: To explore the effects of different intensity aerobic exercises on macular retinal vascular density in patients with primary open angle glaucoma(POAG). <p>METHODS: Prospective case-control study, 88 eyes of 48 patients with POAG diagnosed in our hospital from January 2019 to April 2021 were included(POAG group), 43 cases(86 eyes)were included in the normal control group(control group). The fundus photographic examination without mydriasis was performed with a mydriatic fundus camera, and the operation and film reading were carried out by a special ophthalmologist. Macular vascular density was measured by macular vascular segmentation method. According to macular vascular density, 48 patients with POAG were divided into low vascular density group and high vascular density group, with 24 cases in each group. 48 patients with POAG were instructed to perform treadmill load exercise to compare the vascular density levels in macular area of patients with high intensity(76%-87% HRmax), moderate intensity(64%-75% HRmax)and low intensity(52%-63% HRmax).<p>RESULTS: The vascular density in macular area of control group was significantly higher than that of POAG group; Compared with the high vascular density group, the age and systolic blood pressure were significantly higher in the low vascular density group, and the body weight was significantly lower; In both low and high vascular density groups, the retinal vascular density of macular area under moderate intensity aerobic exercise was significantly higher than that of low intensity and high intensity aerobic exercise; Systolic blood pressure and aerobic exercise were the influencing factors of vascular density in macular area; the above results showed statistically significant differences(<i>P</i><0.05).<p>CONCLUSION: Systolic blood pressure and aerobic exercise are factors affecting macular vascular density, and moderate intensity aerobic exercise can significantly increase macular vascular density.
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@#AIM: To investigate the difference of the optic vessel density in early primary open angle glaucoma(POAG), ocular high tension subjects and healthy subjects. <p>METHODS: A cross-sectional study. From January 2019 to April 2021, patients were selected in the Department of Glaucoma in Fuzhou Southeast Eye Hospital. There were 45 patients(70 eyes)of early POAG group, including 32 males(49 eyes)and 13 females(21 eyes)with age of 48.50(26.75, 64.50)years. There were 37 patients(65 eyes)of ocular high tension group, including 17 males(29 eyes)and 20 females(36 eyes)with age of 37.00(27.00, 47.00)years. There were 51 patients(94 eyes)of healthy group, including 23 males(39 eyes)and 28 females(55 eyes)with age of 46.00(34.50, 56.50)years. Ophthalmic examinations including best-corrected visual acuity(BCVA), intraocular pressure, central corneal thickness(CCT), mean deviations(MD), retinal nerve fiber layers thickness(RNFL)were measured in three groups. The center area, the inner circle area, the outer circle area, and the whole area of the optic vessel density in three groups were measured <i>via</i> optical coherence tomography angiography(OCTA)device.<p>RESULTS: The difference of the intraocular pressure in early POAG group-ocular high tension group was not significant(<i>H</i>=146.876,<i>P</i><0.001), while significantly in early POAG group-healthy group and ocular high tension group-healthy group(all <i>P</i><0.01). Significant differences in BCVA, MD, and RNFL were observed in early POAG group-ocular high tension group(<i>P</i>=0.005, <i>P</i>=0.01, <i>P</i><0.01)and early POAG group-healthy group(<i>P</i>=0.013, <i>P</i><0.01, <i>P</i><0.01), while the difference was not found in ocular high tension group-healthy group(<i>P</i>=1.000, <i>P</i>=0.660, <i>P</i>=1.000). There was no difference of CCT in early POAG group-healthy group(<i>P</i>=0.074), and significant differences were observed in early POAG group-ocular high tension group and ocular high tension group-healthy group(<i>P</i>=0.006, <i>P</i><0.01). The optic vessel density comparison in the center area, the inner circle area, and the whole area were significantly different in early POAG group-ocular high tension group(all <i>P</i><0.01)and in early POAG group-healthy group(all <i>P</i><0.01), which indicated that the optic vessel density was obviously less in the early POAG group than the other two groups. The optic vessel density had no significant difference in ocular high tension group-healthy group in these areas(all <i>P</i>=1.000). In the outer circle area, there were no significant differences of the optic vessel density in early POAG group-ocular high tension group and early POAG group-healthy group(<i>P</i>=0.067, <i>P</i>=0.877), while significant difference was observed in early POAG group-healthy group(<i>P</i>=0.001).<p>CONCLUSION: The optic vessel density was decreased in early POAG comparing with ocular high tension subjects and healthy subjects, which was agree with the changes of MD, RNFL. The optic vessel density decreased firstly from the center area and the inner circle area for early POAG.
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Objective:To investigate the value of counting microvessel density (MVD) and lymphatic vessel density (LVD) in predicting distant metastasis of pancreatic cancer within 1 year after surgery.Methods:The clinicopathological data of 47 patients with pancreatic cancer who underwent surgery in Laibin People's Hospital from January 2020 to December 2021 were retrospectively analyzed. The patients were divided into non-metastasis group( n=24) and metastasis group( n=23) according to whether distant metastasis occurred during 1-year follow-up. Immunohistochemistry was used to detect the CD 34 expression in microvascular epithelial cells and D2-40 level in lymphatic epithelial cells from pancreatic cancer tissues. MVD and LVD in cancer tissues and adjacent normal tissues were counted. The relationship between MVD and LVD in cancer tissues and clinicopathological characteristics such as gender, age, tumor diameter, tumor differentiation, lymph node metastasis, vascular invasion, nerve invasion and tumor stage were analyzed. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated to evaluate the value of MVD and LVD in predicting distant metastasis of pancreatic cancer within 1 year after surgery. The effects of MVD and LVD on the distant metastasis rate of pancreatic cancer within one year after operation were evaluated. Univariate and multivariate logistic regression were used to analyze the independent influencing factors for distant metastasis of pancreatic cancer within 1 year after surgery. Results:MVD and LVD in metastatic cancer tissues were higher than those in adjacent normal tissues [(72.52±9.73) vs (51.73±7.95)/400 times field of view, (23.78±6.87) vs (14.00±5.66)/400 times field of view]. MVD and LVD in the non-metastasis group were also higher than those in the adjacent normal tissues [(63.20±6.52) vs (54.79±5.80)/400 times field of view, (16.25±5.15) vs (13.62±5.03)/400 times field of view], and all the differences were statistically significant ( P<0.05). MVD in cancer tissue was significantly increased in patients with tumor diameter ≥2 cm, lymph node metastasis, vascular invasion and high TNM stage ( P<0.05), and LVD was significantly increased in patients with tumor diameter ≥2 cm, lymph node metastasis, moderate and low differentiation, vascular invasion, nerve invasion and high TNM stage ( P<0.05). The AUC values of MVD and LVD in predicting distant metastasis of pancreatic cancer within 1 year after surgery were 0.799 (95% CI 0.659-0.939) and 0.803(95% CI 0.676-0.929), and the cut-off values were 70.5 and 20.5/400 times field of view, respectively. The sensitivity was 73.9% and 69.6%, and the specificity was 87.5% and 83.7%. The cumulative distant metastasis rate within 1 year after operation in high MVD and high LVD groups was significantly higher than that in low MVD and low LVD groups ( P<0.05). Multivariate logitic regression analysis showed that tumor diameter ≥2 cm ( OR=1.757, 95% CI 1.536-3.846, P<0.05), lymph node metastasis ( OR=2.364, 95% CI 1.036-4.175, P<0.05), high MVD ( OR=4.345, 95% CI 1.245-3.736, P<0.05) and high LVD ( OR=3.637, 95% CI 1.426-4.035, P<0.05) were independent risk factors for distant metastasis of pancreatic cancer within 1 year after surgery. Conclusions:Increased MVD and LVD in pancreatic cancer tissues are independent influencing factors for distant metastasis within 1 year after surgery, which can be used to predict whether patients have distant metastasis within 1 year after surgery.
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Objective:To quantitatively assess the macular and choroidal capillary vessel density and foveal avascular zone (FAZ) variables in untreated central serous chorioretinopathy (CSC), polypoidal choroidal vasculopathy (PCV) patients and healthy people using optical coherence tomography angiography (OCTA), and to investigate their correlation with retinal thickness and choroidal thickness.Methods:A cross-sectional study was adopted.Fifty-five eyes of 55 Chinese adults, including 20 eyes with untreated unilateral CSC, 16 eyes with untreated unilateral PCV and 19 eyes of healthy controls, were enrolled from January 2018 to June 2021 in Shenzhen Aier Eye Hospital Affiliated to Jinan University.The 6 mm×6 mm scanning of Optovue OCTA was carried out in all the subjects.The superficial retinal vessel density (SRVD), deep retinal vessel density (DRVD), outer retinal vessel density (ORVD) and choroidal capillary vessel density (CCVD), FAZ area, FAZ perimeter and vessel density in a 300-μm-wide annular region around FAZ were measured by ReVue software of Optovue OCTA.Central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were assessed by Optovue OCTA HD scan.Correlation between CFT, SFCT and OCTA variable, FAZ variables were evaluated by Pearson liner correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shenzhen Aier Eye Hospital Affiliated to Jinan University (No.AIERKY6236-1). Written informed consent was obtained from each subject prior to entering the cohort.Results:There were significant differences in the foveal, parafoveal and perifoveal SRVD among the three groups ( F=6.344, 9.006, 5.617; all at P<0.01). Compared with healthy control group, the foveal, parafoveal and perifoveal SRVD in CSC group as well as the foveal SRVD in PCV group were significantly increased (all at P<0.01). Compared with CSC group, the parafoveal and perifoveal SRVD were significantly decreased in PCV group (both at P<0.01). There were significantly differences in the parafoveal DRVD among the three groups ( F=3.383, P<0.05). Compared with healthy control group, the parafoveal DRVD of CSC and PCV groups was increased significantly (both at P<0.05). There were significant differences in the ORVD and CCVD among the three groups ( F=16.931, 19.412; both at P<0.001). Compared with healthy control group, the ORVD and CCVD in CSC group and the CCVD in PCV group were decreased significantly (all at P<0.001). Compared with the PVC group, the ORVD was significantly decreased in CSC group ( P<0.001). A significantly difference was found in CFT among the three groups ( F=20.495, P<0.001). Compared with healthy control and PCV group, the CFT was significantly increased in CSC group (both at P<0.001). No significant difference was found in SFCT, FAZ area, FAZ perimeter and vessel density of the 300-μm-wide annular region around FAZ among the three groups ( F=1.083, 0.906, 0.819, 1.530; all at P>0.05). Negative correlations were found between parafoveal DRVD, ORVD and CFT in CSC eyes ( r=-0.555, -0.516; both at P<0.05), and a significant negative correlation was found between ORVD and CFT in PCV eyes ( r=-0.585, P<0.05). No significant correlation was found between OCTA variables (SRVD, DRVD, ORVD, CCVD), FAZ parameters (FAZ area, FAZ perimeter and vessel density of the 300-μm-wide annular region around FAZ) and SFCT in the three groups (all at P>0.05). Conclusions:Hyperaemia in the superficial capillary of macular fovea and atrophy of choroidal capillaries may be the same pathogenesis between CSC and PCV.The vessel density of outer retinal layer is a common independent influencing factor of CFT between the two diseases.
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Microcirculation alterations of the human retina are of significant relevance with glaucoma.Optical coherence tomography angiography (OCTA) is a non-invasive examination that provides signals of the retina and retinal microcirculation.It is currently widely used in research and screening for glaucoma due to its effective detection of each layer in the retinal microcirculation.Vessel density of radial peripapillary capillary (RPC) is positively correlated with the retinal nerve fiber layer thickness, which is crucial in the assessment of glaucoma.Peripapillary region and macula are regions of interest in OCTA analysis for microcirculation.Vessel density of the whole retina and RPC in the peripapillary region decreases significantly, which matches the thinned retinal fiber layer thickness and visual field defects, and is relevant to the disease severity.As for the macular region, vessel density declines while the area of the foveal avascular zone increases.Greater changes in late-stage glaucoma and normal-tension glaucoma are detected by OCTA compared with other stages and types of glaucoma.OCTA imaging may be influenced by high myopia and intraocular pressure, and the peripapillary region is of greater diagnostic value than macula in microcirculation changes.In conclusion, OCTA can serve as a new technique for the assessment of retinal microcirculation in glaucoma.This review summarized the characteristics of retinal microcirculation in OCTA images and its change in peripapillary and macular region in glaucoma eyes.Influencing factors associated with peripapillary and macular microcirculation changes in OCTA images and evaluation of peripapillary and macular microcirculation in glaucoma by OCTA and their diagnostic values were reviewed.
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Objective:To analyze the change of macular microcirculation in early diabetic patients and its correlation with visual acuity.Methods:A cross-sectional study was performed.Seventy-five eyes from 75 patients with non-diabetic retinopathy (NDR) and 33 eyes from 33 patients with non-proliferative diabetic retinopathy (NPDR) were included in Subei People's Hospital Affiliated to Yangzhou University from December 2019 to September 2020.The patients were divided into the NDR group and NPDR group according to their condition.Another 35 eyes from 35 healthy subjects served as the control group.Optical coherence tomography angiography (OCTA) images were acquired over 3 mm×3 mm regions centered on the fovea using RTVue XR OCTA device and the data were quantified with Angio Vue software.The area, perimeter and acircularity index (AI) of the macular foveal avascular zone (FAZ), the grading of abnormal superficial and deep FAZ contour, as well as the vessel density of superficial capillary plexuses (SCP), deep capillary plexuses (DCP) and a 300 μm ring area beside FAZ (FD300) were analyzed and compared among the three groups.The correlations between these indexes and visual acuity were analyzed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Subei People's Hospital affiliated to Yangzhou University (No.2018KY-167). Written informed consent was obtained from each subject prior to any medical examination.Results:No statistically significant differences were found in the FAZ area, FAZ perimeter and AI among the three groups ( F=1.948, P=0.146; F=2.632, P=0.075; H=5.582, P=0.061). The proportions of superficial and deep FAZ contour abnormality were 54.5%(18/33) and 87.9%(29/33) in the NPDR group, 37.3%(28/75) and 70.7%(53/75) in the NDR group, 22.9%(8/35) and 42.9%(15/35) in the control group, respectively, the proportions of superficial and deep FAZ contour abnormality in the NPDR group were significantly higher than those in the control group (both at P<0.05). With the aggravation of the condition, there were more eyes with high grades of abnormal superficial and deep FAZ contours ( χ2=9.827, 9.030; all at P<0.05). The vessel density of parafoveal DCP was (52.50[50.70, 54.80]), (50.40[48.40, 52.60]), (48.30[43.60, 51.55])%, and the vessel density of DCP was (49.90[47.70, 51.80]), (47.30[45.20, 50.10]), (45.80[41.30, 48.60])% in the control group, NDR group and NPDR group respectively, and there were statistically significant differences among the three groups ( H=21.719, 21.652; both at P<0.001), and statistically significant differences were found in pairwise comparisons among the three groups (all at P<0.05). The vessel densities of foveal SCP, foveal DCP and FD300 in the NPDR group were significantly lower than those in the control group (all at P<0.05). There was no statistically significant difference in vessel densities of parafoveal SCP and SCP found in the overall comparison among the three groups ( H=5.290, 5.534; both at P>0.05). In diabetic mellitus patients, there were negative correlations between the vessel density of parafoveal SCP and LogMAR best corrected visual acuity (BCVA), and between the vessel density of SCP and LogMAR BCVA ( rs=-0.305, -0.330; both at P<0.05), and there was a positive correlation between the superficial FAZ contour grading and LogMAR BCVA ( rs=0.353, P<0.05). Conclusions:Abnormal parafoveal DCP and DCP vessel density, as well as FAZ contour, appear in diabetic mellitus patients before the occurrence of visible fundus lesion, and the vessel density of parafoveal SCP and SCP, and superficial FAZ contour grading in diabetic mellitus patients are correlated with visual acuity.OCTA can help monitor disease progression and identify microcirculation parameters that affect visual function.
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@#AIM: To explore the changes of retinal optical coherence tomography angiography(OCTA)vessel density in Patients with Alzheimer's disease(AD)by Meta-analysis, and to explore the value of OCTA in early diagnosis of AD patients.<p>METHODS: Embase, PubMed and Cochrane Library data were searched from January 2016 to September 2021 for relevant studies on vessel density in macular area of AD patients. Two researchers independently screened the literature, extracted the data, and evaluated the risk of inclusion bias using Newcastle-Ottawa Scale(NOS). Meta-analysis was performed using RevMan 5.3 software.<p>RESULTS: A total of 740 cases(eyes)were included in 10 literatures, including 321 cases from the AD group and 419 cases from the control group(age-matched people with normal cognitive abilities). The results of the Meta-analysis showed that the superficial vessel density in macular area of AD patients was lower than that in control group(<i>MD</i>=-1.58, 95%<i>CI</i> -2.60- -0.55, <i>P</i>=0.003). The deep vessel density in macular area of AD patients was lower than that in control group(<i>MD</i>=-2.72, 95%<i>CI</i> -4.36- -1.07, <i>P</i>=0.001). The parafoveal vessel density in AD patients was lower than that in control group(<i>MD</i>=-1.44, 95%<i>CI</i> -1.94- -0.94, <i>P</i><0.00001). The avascular area in the fovea of AD patients was slightly larger than that of the control group(<i>MD</i>=0.05, 95%<i>CI</i> -0.01-0.11, <i>P</i>=0.13).<p>CONCLUSION: The vessel density of each layer in macular area of AD patients were lower than that of control groups the difference was statistically significant. OCTA can assist in the early diagnosis of AD.