RESUMEN

PURPOSE: This study was performed to assess the prevalence of the vascularized foveal zone, including macular-foveal capillaries (MFC) and congenital retinal macrovessels (CRM), and to analyze the structural characteristics of the macular area in patients with MFC. MATERIAL AND METHODS: The first phase of the study evaluated the prevalence of MFC and CRM. Optical coherence tomography angiography (OCT-A) was performed, and OCT-A images of the foveal avascular zone were analyzed. In the second phase, two groups were formed: the MFC group (12 eyes, 9 patients, mean age 43.8±10.7 years) and the control group (18 eyes, 17 patients, mean age 43.0±11.8 years). A comparative analysis was performed assessing central retinal thickness (CRT), thickness of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and foveal pit depth. RESULTS: MFCs were detected in 45 eyes from a total sample of 1031 eyes of 536 patients. The presence of CRM was recorded in three eyes of three patients. RNFL thickness was significantly higher in the MFC group in the inferior parafoveal sector (26.50 [26.00; 29.50] and 24.50 [21.75; 26.50] µm; p=0.022) and in the foveal zone (15.50 [14.00; 16.00] and 12.00 [11.00; 14.00] µm; p=0.017). Additionally, patients with MFC had a higher thickness of GCL and IPL in the fovea, inferior, nasal, and temporal parafoveal sectors. The depth of the foveal pit was significantly lower in the MFC group compared to the control group (83.0 [77.4; 101.6] and 128.0 [107.5; 147.05] µm; p=0.001). CONCLUSION: The prevalence of MFC was 4.36% (calculated per number of eyes), while the prevalence of CRM - 0.29%. The macular area in patients with MFC had increased thickness of the inner retinal layers and decreased depth of the foveal pit, suggesting potential disruption in the natural process of ganglion cell migration and apoptosis during embryogenesis.

Asunto(s)

Fóvea Central , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen , Adulto , Femenino , Masculino , Tomografía de Coherencia Óptica/métodos , Prevalencia , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Capilares/diagnóstico por imagen , Capilares/patología , Enfermedades de la Retina/epidemiología , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Federación de Rusia/epidemiología , Agudeza Visual , Angiografía con Fluoresceína/métodos

RESUMEN

PURPOSE: To evaluate the findings and the correlation of optical coherence tomography angiography and pattern and flash electroretinography in diabetes mellitus without retinopathy. METHODS: Seventy-six eyes of 38 diabetic patients and age- and gender-matched control subjects were included in the study. The foveal avascular zone (FAZ), whole, foveal, parafoveal and perifoveal vascular densities of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillary plexus (CCP) layers were analyzed using optical coherence tomography angiography (OCTA). The amplitudes and implicit times of P50 and N95 waves of the pattern ERG (pERG) and the amplitudes and implicit times of the scotopic and photopic b-waves and oscillatory potentials (OP) of the flash ERG (fERG) tests were evaluated using the Metrovision brand monpack model device. RESULTS: The mean age of the patients was 59.7 ± 7.9 [range 43-79] years. Eighteen (47%) of the patients were female and 20 (53%) were male. The mean duration of diabetes was 7.45 ± 6.2 [range 1-20] years. No significant difference in FAZ area was found between study subjects and controls. Vascular density (VD) values of the superficial capillary plexus (SCP) layer were significantly lower (whole VD, 44.7 ± 3.3 vs. 46.6 ± 3.2%, p = 0.01, foveal VD 16.8 ± 6.4 vs. 24.9 ± 6.1%, p < 0.01, parafoveal VD 45.6 ± 4.5 vs. 47.1 ± 4.4%, p = 0.27 and perifoveal VD 45.5 ± 3.3 vs. 47.3 ± 3.1%, p = 0.01, respectively) in the diabetic group except the parafoveal area. VD measurements in deep and choriocapillary plexuses did not significantly differ between the groups (p > 0.05). ERG tests revealed significantly lower scotopic b-wave amplitudes (130.2 ± 39.3 µV vs.163.3 ± 47.8 µV, p < 0.01) and photopic b-wave amplitudes (83.2 ± 20.7 µV vs. 99.6 ± 29.4 µV, p < 0.01) in the diabetic patients. The implicit time of the photopic responses was significantly prolonged (28.9 ± 1.3 ms vs. 27.8 ± 2.1 ms, p = 0.01) in the patients. Oscillatory potentials in all components consisting of O1 to O4 and the sum of the OP potentials were lower in the diabetic group than the control subjects (p < 0.001). The P50 and N95 amplitudes and implicit times were comparable between the groups (p > 0.05). Correlation analysis showed a positive correlation between N95 amplitudes in pERG and the superficial vessel densities in OCTA (r = 0.26, p = 0.04). A negative correlation was found between photopic implicit times in fERG and the choriocapillary vessel densities (r=-0.27, p = 0.03). CONCLUSION: OCTA revealed decreased superficial vascular densities with the onset of the metabolic process of diabetes mellitus. As a result of these structural changes, lower scotopic and photopic amplitudes, decreased OP amplitudes, and prolonged implicit times in flash ERG were obtained.

Asunto(s)

Electrorretinografía , Tomografía de Coherencia Óptica , Humanos , Electrorretinografía/métodos , Masculino , Tomografía de Coherencia Óptica/métodos , Femenino , Persona de Mediana Edad , Anciano , Adulto , Angiografía con Fluoresceína/métodos , Retinopatía Diabética/fisiopatología , Retinopatía Diabética/diagnóstico por imagen , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/fisiopatología , Estudios de Casos y Controles , Fóvea Central/diagnóstico por imagen , Fóvea Central/irrigación sanguínea , Fóvea Central/fisiopatología , Diabetes Mellitus/fisiopatología , Diabetes Mellitus/diagnóstico por imagen , Retina/diagnóstico por imagen , Retina/fisiopatología

RESUMEN

This study was intended to investigate the macular vascular and photoreceptor changes for diabetic macular edema (DME) at the early stage. A total of 255 eyes of 134 diabetes mellitus patients were enrolled and underwent an ophthalmological and systemic evaluation in this cross-sectional study. Early DME was characterized by central subfoveal thickness (CST) value between 250 and 325 µm, intact ellipsoid zone, and an external limiting membrane. While non-DME was characterized by CST < 250 µm with normal retinal morphology and structure. Foveal avascular zone (FAZ) area ≤ 0.3 mm2 (P < 0.001, OR = 0.41, 95% CI 0.26-0.67 in the multivariate analysis) and HbA1c level ≤ 8% (P = 0.005, OR = 0.37, 95% CI 0.19-0.74 in multivariate analysis) were significantly associated with a higher risk of early DME. Meanwhile, no significant differences exist in cone parameters between non-DME and early DME eyes. Compared with non-DME eyes, vessel diameter, vessel wall thickness, wall-to-lumen ratio, the cross-sectional area of the vascular wall in the upper side were significantly decreased in the early DME eyes (P = 0.001, P < 0.001, P = 0.005, P = 0.003 respectively). This study suggested a vasospasm or vasoconstriction with limited further photoreceptor impairment at the early stage of DME formation. CST ≥ 250 µm and FAZ ≤ 0.3 mm2 may be the indicator for early DME detection.

Asunto(s)

Retinopatía Diabética , Edema Macular , Vasos Retinianos , Humanos , Edema Macular/patología , Edema Macular/etiología , Edema Macular/diagnóstico por imagen , Masculino , Femenino , Retinopatía Diabética/patología , Retinopatía Diabética/diagnóstico por imagen , Persona de Mediana Edad , Estudios Transversales , Anciano , Vasos Retinianos/patología , Vasos Retinianos/diagnóstico por imagen , Mácula Lútea/patología , Mácula Lútea/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Fóvea Central/patología , Fóvea Central/diagnóstico por imagen

RESUMEN

PURPOSE: To describe macular pucker contraction patterns with en face optical coherence tomography (OCT), to provide a correlation with metamorphopsia scores, and to discuss the protective role of the Henle fiber layer (HFL) against tangential traction. METHODS: Retrospective, institutional, observational, and consecutive case series. Clinical charts, M-charts scores, and structural and en face OCT imaging of patients diagnosed with macular pucker were reviewed. RESULTS: A 120 eyes of 114 consecutive patients diagnosed with macular pucker were included. En face OCT patterns of macular pucker contraction were foveal in 51 of 120 eyes (42.5%) and extrafoveal in 69 of 120 eyes (57.5%). Foveal macular puckers had regular, a concentric, circle morphology in the HFL (46/51 eyes, 90.2%), whereas extrafoveal membranes had irregular, distorted, circular HFL morphology (62/69 eyes, 89.8%; P < 0.001). Foveal contraction morphology and regular HFL pattern, as well as extrafoveal contraction morphology and an irregular HFL pattern, highly correlated one with another (P < 0.001 in both cases). Foveal macular puckers with regular HFL patterns had significantly less vertical and horizontal M-charts scores as compared with extrafoveal membranes with irregular HFL (P < 0.001 in both cases). Ellipsoid zone and external limiting membrane defects were rare in the parafoveal region (5/120 eyes, 4.2%). Visual acuity did not correlate with metamorphopsia scores (P = 0.903). CONCLUSION: En face OCT imaging identifies macular pucker contraction patterns that correlate with metamorphopsia scores and that can be used alongside the current structural OCT staging system to guide clinicians in the surgical decision-making process.

Asunto(s)

Tomografía de Coherencia Óptica , Trastornos de la Visión , Agudeza Visual , Humanos , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Femenino , Masculino , Anciano , Agudeza Visual/fisiología , Persona de Mediana Edad , Trastornos de la Visión/fisiopatología , Trastornos de la Visión/diagnóstico , Mácula Lútea/diagnóstico por imagen , Mácula Lútea/patología , Anciano de 80 o más Años , Fóvea Central/diagnóstico por imagen , Fóvea Central/patología

RESUMEN

AIM: The study aims to compare choroidal thickness, deep and superficial retinal capillary plexuses, and foveal avascular zone (FAZ) parameters in elite martial arts athletes and a healthy sedentary control group. METHODS: The study included martial arts athletes (32 individuals, 64 eyes) and healthy sedentary persons (43 individuals with healthy sedentary lifestyles, 86 eyes) aged 18-35 years. In this single non-repeated observational and cross-sectional study, choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ measurements were measured using Swept-source optical coherence tomography angiography (SS-OCTA) and compared between groups. RESULTS: No statistically significant differences were found (p > 0.05) in age, IOP, AL (axial length), and best-corrected visual acuity (BCVA) parameters between groups. There were no statistically significant differences between the groups in choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ parameters determined by the OCTA method (p > 0.05). CONCLUSION: In our study, we observed that the retinal and choroidal structures of martial art athletes and healthy sedentary individuals were similar. This observation implies that the putative microvascular effects on the choroid and retina in martial arts, especially those based on the anaerobic energy system, may reflect similar outcomes to those observed in individuals with sedentary lifestyles characterized by healthiness.

Asunto(s)

Coroides , Fóvea Central , Artes Marciales , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Artes Marciales/fisiología , Adulto , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Coroides/anatomía & histología , Masculino , Estudios Transversales , Tomografía de Coherencia Óptica/métodos , Adolescente , Femenino , Fóvea Central/diagnóstico por imagen , Adulto Joven , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/anatomía & histología , Atletas , Conducta Sedentaria , Angiografía con Fluoresceína/métodos

Asunto(s)

Fóvea Central , Tomografía de Coherencia Óptica , Humanos , Fóvea Central/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodos , Agudeza Visual/fisiología , Masculino , Fondo de Ojo , Femenino

RESUMEN

Aim of the present study is to evaluate the relationship between genetic and phenotypic data in a series of patients affected by grade I and II of foveal hypoplasia with stable fixation and good visual acuity using multimodal imaging techniques. All patients underwent complete clinical and instrumental assessment including structural Optical Coherence Tomography (OCT), OCT Angiography and Adaptive Optics (AO) imaging. Central macular thickness (CMT), inner nuclear layer (INL), vessel density in superficial capillary plexus were the main variables evaluated with OCT technology. Cone density, cone spacing, cone regularity, cone dispersion and angular density were the parameters evaluated with AO. Genetic evaluation and trio exome sequencing were performed in all affected individuals. Eight patients (3 males and 5 females) with a mean age of 12.62 years (range 8-18) were enrolled. The mean best corrected visual acuity (BCVA) was 0.18 ± 0.13 logMAR, mean CMT was 291.9 ± 16.6 µm and INL was 26.2 ± 4.6 µm. The absence of a foveal avascular zone (FAZ) was documented by examination of OCT-A in seven patients in the superficial capillary plexus. However, there was a partial FAZ in the deep plexus in patients P5 and P8. Of note, all the patients presented with major retinal vessels clearly crossing the foveal center. All individuals exhibited a grade I or II of foveal hypoplasia. In 5 patients molecular analyses showed an extremely mild form of albinism caused by compound heterozygosity of a TYR pathogenic variant and the hypomorphic p.[Ser192Tyr;Arg402Gln] haplotype. One patient had Waardenburg syndrome type 2A caused by a de novo variant in MITF. Two patients had inconclusive molecular analyses. All the patients displayed abnormalities on OCT-A. Photoreceptor count did not differ from normal subjects according to the current literature, but qualitative analysis of AO imaging showed distinctive features likely related to an abnormal pigment distribution in this subset of individuals. In patients with foveal hypoplasia, genetic and multimodal imaging data, including AO findings, can help understand the physiopathology of the foveal hypoplasia phenotype. This study confirms that cone density and visual function can both be preserved despite the absence of a pit.

Asunto(s)

Fóvea Central , Imagen Multimodal , Fenotipo , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Masculino , Niño , Femenino , Adolescente , Tomografía de Coherencia Óptica/métodos , Fóvea Central/anomalías , Fóvea Central/patología , Fóvea Central/diagnóstico por imagen , Imagen Multimodal/métodos , Angiografía con Fluoresceína/métodos , Albinismo/genética

RESUMEN

PURPOSE: To investigate the preoperative choriocapillaris perfusion (CCP) as a biomarker in patients with idiopathic epiretinal membrane (iERM). MATERIALS AND METHODS: 28 patients (28 eyes) with unilateral iERM who received pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling were included for retrospective observational study. Optical coherence tomography (OCT) and angiography (OCTA) was performed before and after PPV. Area, perimeter, and circularity of superficial foveal avascular zone (FAZ) were analyzed preoperatively in both eyes using OCTA. Preoperative CCP was also analyzed with binarized en-face OCTA images. Measurements of best-corrected visual acuity (BCVA) and central foveal thickness (CFT) by OCT were conducted at the baseline and 6 months following the surgery. The correlations of preoperative OCT parameters with postoperative BCVA and CFT reduction were analyzed. RESULTS: CCP was significantly lower (p < 0.001) and FAZ had shrunk (p < 0.001) in eyes with iERM compared to unaffected fellow eyes before surgery. BCVA and CFT became significantly improved after surgery (p = 0.001, p < 0.001). Multiple regression analysis revealed that preoperative CCP was significantly related with BCVA improvement (ß = 0.185, p = 0.005), postoperative BCVA (ß = 0.108, p = 0.023) and ratio of post- to preoperative CFT (ß = 0.106, p = 0.044). CONCLUSIONS: Preoperative CCP is a biomarker for poor functional and anatomical prognosis after surgery in iERM.

Asunto(s)

Biomarcadores , Coroides , Membrana Epirretinal , Tomografía de Coherencia Óptica , Vitrectomía , Humanos , Membrana Epirretinal/cirugía , Membrana Epirretinal/diagnóstico por imagen , Membrana Epirretinal/patología , Masculino , Femenino , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Coroides/patología , Anciano , Tomografía de Coherencia Óptica/métodos , Persona de Mediana Edad , Estudios Retrospectivos , Agudeza Visual , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen , Fóvea Central/patología , Angiografía con Fluoresceína/métodos

RESUMEN

Purpose: This study aims at linking subtle changes of fixational eye movements (FEM) in controls and in patients with foveal drusen using adaptive optics retinal imaging in order to find anatomo-functional markers for pre-symptomatic age-related macular degeneration (AMD). Methods: We recruited 7 young controls, 4 older controls, and 16 patients with presymptomatic AMD with foveal drusen from the Silversight Cohort. A high-speed research-grade adaptive optics flood illumination ophthalmoscope (AO-FIO) was used for monocular retinal tracking of fixational eye movements. The system allows for sub-arcminute resolution, and high-speed and distortion-free imaging of the foveal area. Foveal drusen position and size were documented using gaze-dependent imaging on a clinical-grade AO-FIO. Results: FEM were measured with high precision (RMS-S2S = 0.0015 degrees on human eyes) and small foveal drusen (median diameter = 60 µm) were detected with high contrast imaging. Microsaccade amplitude, drift diffusion coefficient, and ISOline area (ISOA) were significantly larger for patients with foveal drusen compared with controls. Among the drusen participants, microsaccade amplitude was correlated to drusen eccentricity from the center of the fovea. Conclusions: A novel high-speed high-precision retinal tracking technique allowed for the characterization of FEM at the microscopic level. Foveal drusen altered fixation stability, resulting in compensatory FEM changes. Particularly, drusen at the foveolar level seemed to have a stronger impact on microsaccade amplitudes and ISOA. The unexpected anatomo-functional link between small foveal drusen and fixation stability opens up a new perspective of detecting oculomotor signatures of eye diseases at the presymptomatic stage.

Asunto(s)

Fijación Ocular , Fóvea Central , Degeneración Macular , Drusas Retinianas , Humanos , Femenino , Drusas Retinianas/fisiopatología , Drusas Retinianas/diagnóstico , Masculino , Fijación Ocular/fisiología , Fóvea Central/diagnóstico por imagen , Fóvea Central/fisiopatología , Fóvea Central/patología , Anciano , Persona de Mediana Edad , Degeneración Macular/fisiopatología , Degeneración Macular/diagnóstico , Adulto , Tomografía de Coherencia Óptica/métodos , Oftalmoscopía/métodos , Agudeza Visual/fisiología , Movimientos Sacádicos/fisiología , Síntomas Prodrómicos

RESUMEN

Purpose: In aging and early-intermediate age-related macular degeneration (AMD), rod-mediated dark adaptation (RMDA) slows more at 5° superior than at 12°. Using optical coherence tomography angiography (OCTA), we asked whether choriocapillaris flow deficits are related to distance from the fovea. Methods: Persons ≥60 years stratified for AMD via the Age-Related Eye Disease Study's nine-step system underwent RMDA testing. Two adjacent 4.4° × 4.4° choriocapillaris OCTA slabs were centered on the fovea and 12° superior. Flow signal deficits (FD%) in concentric arcs (outer radii in mm, 0.5, 1.5, 2.2, 4.0, and 5.0 superior) were correlated with rod intercept time (RIT) and best-corrected visual acuity (BCVA). Results: In 366 eyes (170 normal, 111 early AMD, 85 intermediate AMD), FD% was significantly worse with greater AMD severity in all regions (overall P < 0.05) and poorest under the fovea (P < 0.0001). In pairwise comparisons, FD% worsened with greater AMD severity (P < 0.05) at distances <2.2 mm. At greater distances, eyes with intermediate, but not early AMD differed from normal eyes. Foveal FD% was more strongly associated with longer RIT at 5° (r = 0.52) than RIT at 12° (r = 0.39) and BCVA (r = 0.21; all P < 0.0001). Choroidal thickness was weakly associated with longer RIT at 5° and 12° (r = 0.10-0.20, P < 0.05) and not associated with AMD severity. Conclusions: Reduced transport across the choriocapillaris-Bruch's membrane-retinal pigment epithelium complex, which contributes to drusen formation under the macula lutea (and fovea), may also reduce retinoid resupply to rods encircling the high-risk area. FD% has potential as a functionally validated imaging biomarker for AMD emergence.

Asunto(s)

Envejecimiento , Coroides , Adaptación a la Oscuridad , Angiografía con Fluoresceína , Fóvea Central , Degeneración Macular , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Masculino , Anciano , Femenino , Agudeza Visual/fisiología , Fóvea Central/diagnóstico por imagen , Fóvea Central/patología , Fóvea Central/irrigación sanguínea , Fóvea Central/fisiopatología , Envejecimiento/fisiología , Persona de Mediana Edad , Degeneración Macular/fisiopatología , Angiografía con Fluoresceína/métodos , Anciano de 80 o más Años , Adaptación a la Oscuridad/fisiología

RESUMEN

Geographic atrophy (GA) is an advanced form of dry age-related macular degeneration (AMD) that leads to progressive and irreversible vision loss. Identifying patients with greatest risk of GA progression is important for targeted utilization of emerging therapies. This study aimed to comprehensively evaluate the role of shape-based fractal dimension features ( F fd ) of sub-retinal pigment epithelium (sub-RPE) compartment and texture-based radiomics features ( F t ) of Ellipsoid Zone (EZ)-RPE and sub-RPE compartments for risk stratification for subfoveal GA (sfGA) progression. This was a retrospective study of 137 dry AMD subjects with a 5-year follow-up. Based on sfGA status at year 5, eyes were categorized as Progressors and Non-progressors. A total of 15 shape-based F fd of sub-RPE surface and 494 F t from each of sub-RPE and EZ-RPE compartments were extracted from baseline spectral domain-optical coherence tomography scans. The top nine features were identified from F fd and F t feature pool separately using minimum Redundancy maximum Relevance feature selection and used to train a Random Forest (RF) classifier independently using three-fold cross validation on the training set ( S t , N = 90) to distinguish between sfGA Progressors and Non-progressors. Combined F fd and F t was also evaluated in predicting risk of sfGA progression. The RF classifier yielded AUC of 0.85, 0.79 and 0.89 on independent test set ( S v , N = 47) using F fd , F t , and their combination, respectively. Using combined F fd and F t , the improvement in AUC was statistically significant on S v with p-values of 0.032 and 0.04 compared to using only F fd and only F t , respectively. Combined F fd and F t appears to identify high-risk patients. Our results show that FD and texture features could be potentially used for predicting risk of sfGA progression and future therapeutic response.

Asunto(s)

Progresión de la Enfermedad , Atrofia Geográfica , Epitelio Pigmentado de la Retina , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Atrofia Geográfica/diagnóstico por imagen , Atrofia Geográfica/patología , Femenino , Masculino , Anciano , Estudios Retrospectivos , Epitelio Pigmentado de la Retina/diagnóstico por imagen , Epitelio Pigmentado de la Retina/patología , Fóvea Central/diagnóstico por imagen , Fóvea Central/patología , Persona de Mediana Edad , Anciano de 80 o más Años , Degeneración Macular/diagnóstico por imagen , Degeneración Macular/patología

RESUMEN

Migraine, classified as a neurovascular disease, has been identified as a potential risk factor for ocular vascular complications. Our study aimed to compare retinal vessel density and perfusion density between subjects with migraine and healthy subjects using optical coherence tomography angiography (OCTA). In this cross-sectional case-control study, we enrolled 30 migraine subjects with aura (MWA), 30 migraine subjects without aura (MWOA) and 30 age and gender-matched healthy controls (HC). The foveal avascular zone (FAZ) in superficial capillary plexus (SCP), Vessel density (VD) and perfusion density (PD) in SCP and deep capillary plexus (DCP) were assessed in a 3 × 3 mm scan of the macula with the swept source OCT. Results indicated that the FAZ of MWA and MWOA subjects was significantly larger from HC. Also, FAZ of MWA was larger from MWOA. VD and PD in both SCP and DCP were significantly reduced in both MWA and MWOA groups compared to HC. However, VD and PD did not show significant differences among MWA and MWOA. Additionally, the duration of disease was the main determinant of the FAZ. In conclusion, the FAZ in the SCP, VD and PD in the SCP and DCP of the macula were affected in both MWA and MWOA. FAZ, specifically, was increased with the evolution of the disease. These findings might contribute to an increased risk of ocular vascular complications among subjects with migraine and could potentially use OCTA as a biomarker for this population.

Asunto(s)

Fóvea Central , Migraña con Aura , Migraña sin Aura , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Femenino , Masculino , Adulto , Estudios Transversales , Tomografía de Coherencia Óptica/métodos , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen , Fóvea Central/patología , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patología , Estudios de Casos y Controles , Migraña con Aura/diagnóstico por imagen , Migraña con Aura/fisiopatología , Migraña sin Aura/diagnóstico por imagen , Migraña sin Aura/fisiopatología , Persona de Mediana Edad , Adulto Joven

Asunto(s)

Estrías Angioides , Lesiones Oculares , Seudoxantoma Elástico , Hemorragia Retiniana , Heridas no Penetrantes , Humanos , Seudoxantoma Elástico/complicaciones , Hemorragia Retiniana/etiología , Estrías Angioides/etiología , Estrías Angioides/complicaciones , Heridas no Penetrantes/complicaciones , Lesiones Oculares/complicaciones , Lesiones Oculares/etiología , Masculino , Fóvea Central/diagnóstico por imagen

RESUMEN

Purpose: To assess longitudinal reproducibility of metrics of foveal density (peak cone density [PCD], cone density centroid [CDC], and 80th percentile centroid area) in participants with normal vision. Methods: Participants (n = 19; five male and 14 female) were imaged at two time points (average interval of 3.2 years) using an adaptive optics scanning light ophthalmoscope (AOSLO). Foveally centered regions of interest (ROIs) were extracted from AOSLO montages. Cone coordinate matrices were semiautomatically derived for each ROI, and cone mosaic metrics were calculated. Results: On average, there were no significant changes in cone mosaic metrics between visits. The average ± SD PCD was 187,000 ± 20,000 cones/mm2 and 189,000 ± 21,700 cones/mm2 for visits 1 and 2, respectively (P = 0.52). The average ± SD density at the CDC was 183,000 ± 19,000 cones/mm2 and 184,000 ± 20,800 cones/mm2 for visits 1 and 2, respectively (P = 0.78). The average ± SD 80th percentile isodensity contour area was 15,400 ± 1800 µm2 and 15,600 ± 1910 µm2 for visits 1 and 2, respectively (P = 0.57). Conclusions: Foveal cone mosaic density metrics were highly reproducible in the cohort examined here, although further study is required in more diverse populations. Translational Relevance: Determination of the normative longitudinal changes in foveal cone topography is key for evaluating longitudinal measures of foveal cone topography in patients with progressive retinal dystrophies.

Asunto(s)

Fóvea Central , Células Fotorreceptoras Retinianas Conos , Humanos , Masculino , Fóvea Central/diagnóstico por imagen , Femenino , Adulto , Reproducibilidad de los Resultados , Persona de Mediana Edad , Recuento de Células , Adulto Joven , Oftalmoscopía/métodos , Tomografía de Coherencia Óptica/métodos , Agudeza Visual/fisiología

RESUMEN

PURPOSE: The aim of this study is to analyse whether optical coherence tomography angiography (angio-OCT, OCTA) measurements can be a useful tool to differentiate central nervous system (CNS) involvement in rheumatic disorders (RD) from multiple sclerosis (MS). METHODS: A total of 85 patients- 41 with MS, 21 with RD with CNS involvement and 23 healthy controls were included in the study. All individuals underwent OCTA and the following parameters were measured in each eye separately: average foveal and parafoveal vessel density (VD), average foveal and parafoveal vessel length (VL) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as area, perimeter, and circularity of the foveal avascular zone. RESULTS: OCTA showed a VD reduction in the foveal region of the SCP in eyes of RD patients when compared to MS patients (21.96 ± 3.39 vs.23.88 ± 3.05 (p = 0.003)). There have been no significant differences in any of the assessed parameters that is average VD and total average VL in the foveal area of the SCP as well as of the DCP in the general population comprising healthy controls, MS and RD groups (p > 0.05 for all). CONCLUSIONS: Our results suggest that an OCTA finding of decreased VD in the foveal region of the SCP may be considered as a potentially useful biomarker of RD in comparison with MS patients.

Asunto(s)

Angiografía con Fluoresceína , Esclerosis Múltiple , Vasos Retinianos , Enfermedades Reumáticas , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Masculino , Femenino , Esclerosis Múltiple/diagnóstico , Adulto , Diagnóstico Diferencial , Angiografía con Fluoresceína/métodos , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patología , Enfermedades Reumáticas/diagnóstico , Fondo de Ojo , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen

RESUMEN

SIGNIFICANCE: An understanding of factors that affect the foveal avascular zone (FAZ) in healthy eyes may aid in the early identification of patients at risk of retinal pathology, thereby allowing better management and preventive measures to be implemented. PURPOSE: The size and shape of the FAZ can change due to retinal diseases associated with oxidative stress, including diabetic retinopathy, glaucoma, and macular degeneration. This study aimed to assess the relationship, if any, between factors that may affect the superficial FAZ (i.e., vessel density, vessel perfusion, overweight/obesity) and possible links with macular pigment optical density in young, healthy participants. METHODS: One hundred thirty-nine participants aged 18 to 35 years were recruited to this cross-sectional study. The superficial FAZ area, foveal vascularity, and central macular thickness (CMT) were assessed using the Cirrus 5000. Health parameters, body mass index, trunk fat %, and macular pigment were analyzed to determine possible associations with the superficial FAZ. RESULTS: Mean FAZ area was 0.23 ± 0.08 mm2. Females had a significantly larger mean FAZ area than males (p=0.002). The FAZ area was positively correlated with body mass index (Pearson's r = 0.189, p=0.026). Significant correlates of the FAZ area in the multivariate model included vessel perfusion (central), CMT, and trunk fat %, collectively explaining 65.1% of the overall variability. CONCLUSIONS: Study findings suggest that reduced vessel perfusion, thinner CMT, and higher trunk fat % are plausible predictors of a larger FAZ area in healthy Caucasian adults. Low macular pigment optical density was, however, not associated with increased FAZ size in young healthy eyes. Noninvasive optical coherence tomography angiography testing, in association with these predictors, may aid in the early detection and monitoring of retinal diseases associated with oxidative stress.

Asunto(s)

Angiografía con Fluoresceína , Fóvea Central , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Femenino , Masculino , Adulto , Estudios Transversales , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen , Adulto Joven , Adolescente , Angiografía con Fluoresceína/métodos , Vasos Retinianos/diagnóstico por imagen , Fondo de Ojo , Voluntarios Sanos , Índice de Masa Corporal

RESUMEN

Purpose: To explore differences in the relationship between gestational age (GA) and birth weight (BW) percentile and ocular geometry between males and females. Methods: The Gutenberg Prematurity Eye Study involved a prospective ophthalmic examination of adults, aged 18 to 52 years, who were born preterm or at term, in Germany. The associations between GA and BW percentile on the main outcome measures were evaluated by uni- and multivariable linear regression analyses. The main outcome measures were central corneal thickness, corneal radius, anterior chamber depth, lens thickness, posterior segment length, and central foveal thickness. Potential sex-specific differences and an effect modification by sex were analyzed. Results: This study involved 438 participants (245 females, 193 males) with an average age of 28.6 ± 8.7 years. In female participants, central foveal thickness was negatively associated with a higher GA (B = -2.99; P < 0.001). Similarly, male participants also demonstrated a negative association between central foveal thickness and GA (B = -4.27; P < 0.001). The multivariable model with effect modification revealed that the central foveal thickness was thicker with lower GA. There was an association between the effect modification of GA with sex and central foveal thickness, demonstrating a more pronounced effect of GA on central foveal thickness in male participants (B = 1.29; P = 0.04). Conclusions: This study identified a sex-specific correlation between lower GA and thicker central foveal thickness, suggesting differences in the developmental trajectory of this biometric parameter concerning GA. A thicker central foveal thickness might affect the visual acuity of individuals born preterm in adulthood, with a more pronounced impact in males and a potential predisposition to age-related diseases later in life. Sex did not influence the association of GA or BW percentile to other ocular geometric parameters.

Asunto(s)

Peso al Nacer , Edad Gestacional , Humanos , Masculino , Femenino , Estudios Prospectivos , Adulto , Adulto Joven , Adolescente , Persona de Mediana Edad , Peso al Nacer/fisiología , Factores Sexuales , Recién Nacido , Fóvea Central/diagnóstico por imagen , Córnea/anatomía & histología , Córnea/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Cámara Anterior/diagnóstico por imagen , Cámara Anterior/anatomía & histología , Recien Nacido Prematuro , Cristalino/diagnóstico por imagen , Cristalino/anatomía & histología , Alemania , Agudeza Visual/fisiología , Segmento Posterior del Ojo/diagnóstico por imagen , Segmento Posterior del Ojo/anatomía & histología , Segmento Posterior del Ojo/patología

RESUMEN

Purpose: To develop Choroidalyzer, an open-source, end-to-end pipeline for segmenting the choroid region, vessels, and fovea, and deriving choroidal thickness, area, and vascular index. Methods: We used 5600 OCT B-scans (233 subjects, six systemic disease cohorts, three device types, two manufacturers). To generate region and vessel ground-truths, we used state-of-the-art automatic methods following manual correction of inaccurate segmentations, with foveal positions manually annotated. We trained a U-Net deep learning model to detect the region, vessels, and fovea to calculate choroid thickness, area, and vascular index in a fovea-centered region of interest. We analyzed segmentation agreement (AUC, Dice) and choroid metrics agreement (Pearson, Spearman, mean absolute error [MAE]) in internal and external test sets. We compared Choroidalyzer to two manual graders on a small subset of external test images and examined cases of high error. Results: Choroidalyzer took 0.299 seconds per image on a standard laptop and achieved excellent region (Dice: internal 0.9789, external 0.9749), very good vessel segmentation performance (Dice: internal 0.8817, external 0.8703), and excellent fovea location prediction (MAE: internal 3.9 pixels, external 3.4 pixels). For thickness, area, and vascular index, Pearson correlations were 0.9754, 0.9815, and 0.8285 (internal)/0.9831, 0.9779, 0.7948 (external), respectively (all P < 0.0001). Choroidalyzer's agreement with graders was comparable to the intergrader agreement across all metrics. Conclusions: Choroidalyzer is an open-source, end-to-end pipeline that accurately segments the choroid and reliably extracts thickness, area, and vascular index. Especially choroidal vessel segmentation is a difficult and subjective task, and fully automatic methods like Choroidalyzer could provide objectivity and standardization.

Asunto(s)

Coroides , Tomografía de Coherencia Óptica , Humanos , Coroides/irrigación sanguínea , Coroides/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Aprendizaje Profundo , Vasos Retinianos/diagnóstico por imagen , Fóvea Central/diagnóstico por imagen , Fóvea Central/irrigación sanguínea , Adulto , Reproducibilidad de los Resultados

RESUMEN

Purpose: To evaluate microvascular intereye differences in diabetic patients with same-stage diabetic retinopathy (DR) in both eyes as assessed using optical coherence tomography angiography (OCTA). Methods: In this cross-sectional study, fovea-centered swept-source 6 × 6 mm OCTA scans were acquired using a 200 kHz OCTA device. Vessel density (VD) and fractal dimension were calculated on binarized, vessel-segmented images in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Foveal avascular zone (FAZ) area (FAZA) and perimeter (FAZP) was measured and FAZ circularity (FAZC) calculated. Absolute difference (δabs) and asymmetry index between eyes was assessed and compared across DR stages. Differences of VD, FD, and FAZ parameters between left and right eye were evaluated using linear mixed models. Results: A total of 336 eyes of 168 diabetic patients without DR and with DR stages ranging from mild nonproliferative to proliferative DR were included for analysis. The intereye comparison revealed significantly lower VD in the SCP (estimate [95% CI] = -0.009 [-0.01; -0.006], P < 0.01), as well as a significantly lower FD in the SCP (-0.007 [-0.009; -0.005], P < 0.01) of the left compared to the right eye. FAZC of the left compared to the right eye was lower in eyes without DR, moderate DR, and PDR (P < 0.05). FAZ δabs and asymmetry index were higher in more advanced disease stages (P < 0.05). Conclusions: OCTA metrics provide important information on the retinal microvasculature in systemic diseases such as DR. Our results reveal a significant intereye difference with lower VD and FD in the SCP as well as higher FAZ impairment of the left compared to the right eye.

Asunto(s)

Retinopatía Diabética , Angiografía con Fluoresceína , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/fisiopatología , Retinopatía Diabética/diagnóstico por imagen , Estudios Transversales , Tomografía de Coherencia Óptica/métodos , Masculino , Femenino , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patología , Angiografía con Fluoresceína/métodos , Anciano , Densidad Microvascular , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen , Fóvea Central/patología , Adulto , Fondo de Ojo , Capilares/patología , Capilares/diagnóstico por imagen , Microvasos/patología , Microvasos/diagnóstico por imagen , Agudeza Visual/fisiología

RESUMEN

BACKGROUND: Cerebral microvascular dysfunction is a promising area for research into the pathogenesis of major depressive disorder (MDD) and bipolar disorder (BD). Despite the scientific and clinical potential of studying microvascular dysfunction, progress in this area has long been hampered by the lack of methods to study microvessels intravitally. AIMS: The aim of the present study was to search for potential optical coherence tomography (OCT) and OCT-angiography (OCTA) biomarkers of BD and MDD. METHODS: One hundred and five consecutive patients with a current depressive episode were enrolled in the study (39 - BD and 66 - MDD). In addition, forty-one generally healthy subjects were enrolled as a control group. Only the right eye was examined in all subjects. Structural OCT and OCTA scans with signal strength ≥7 were included. RESULTS: Structural OCT measurements showed no significant differences between the groups. OCTA measurements of foveal avascular zone (FAZ), area and skeleton density showed a decrease in the retinal capillary bed in BD patients, whereas OCTA values in MDD patients did not differ from the control group. Several significant differences were found between the BD and control groups. In the BD group, the FAZ of the deep capillary plexus was increased, reflecting a reduction in capillary perfusion in the central subfield of this plexus. CONCLUSIONS: OCTA measurements of FAZ, area and skeleton density showed a decrease in the retinal capillary bed in BD patients, whereas OCTA values in MDD patients did not differ from the control group.

Asunto(s)

Trastorno Bipolar , Trastorno Depresivo Mayor , Tomografía de Coherencia Óptica , Humanos , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Bipolar/diagnóstico por imagen , Trastorno Bipolar/fisiopatología , Femenino , Masculino , Adulto , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patología , Fóvea Central/diagnóstico por imagen , Fóvea Central/irrigación sanguínea