AIM:To evaluate the predictive value of superficial retinal capillary plexus(SRCP)and radial peripapillary capillary(RPC)for visual field recovery after optic cross decompression and compare them with peripapillary ne...AIM:To evaluate the predictive value of superficial retinal capillary plexus(SRCP)and radial peripapillary capillary(RPC)for visual field recovery after optic cross decompression and compare them with peripapillary nerve fiber layer(pRNFL)and ganglion cell complex(GCC).METHODS:This prospective longitudinal observational study included patients with chiasmal compression due to sellar region mass scheduled for decompressive surgery.Generalized estimating equations were used to compare retinal vessel density and retinal layer thickness preand post-operatively and with healthy controls.Logistic regression models were used to assess the relationship between preoperative GCC,pRNFL,SRCP,and RPC parameters and visual field recovery after surgery.RESULTS:The study included 43 eyes of 24 patients and 48 eyes of 24 healthy controls.Preoperative RPC and SRCP vessel density and pRNFL and GCC thickness were lower than healthy controls and higher than postoperative values.The best predictive GCC and pRNFL models were based on the superior GCC[area under the curve(AUC)=0.866]and the tempo-inferior pRNFL(AUC=0.824),and the best predictive SRCP and RPC models were based on the nasal SRCP(AUC=0.718)and tempo-inferior RPC(AUC=0.825).There was no statistical difference in the predictive value of the superior GCC,tempo-inferior pRNFL,and tempo-inferior RPC(all P>0.05).CONCLUSION:Compression of the optic chiasm by tumors in the saddle area can reduce retinal thickness and blood perfusion.This reduction persists despite the recovery of the visual field after decompression surgery.GCC,pRNFL,and RPC can be used as sensitive predictors of visual field recovery after decompression surgery.展开更多
AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control...AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control subjects were enrolled in the study.One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm^(2) rectangular area.Radial peripapillary capillary(RPC)density,peripapillary retinal nerve fiber layer(pRNFL)thickness,cup volume,rim area,disc area,cup-to-disc(c/d)area ratio,and vertical c/d ratio were obtained automatically using device software.Automated parapapillary choroidal microvasculature(PPCMv)density was calculated using MATLAB software.When the vertical c/d ratio of the optic disc was absent or small cup,it was considered as a crowded disc.RESULTS:The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes(P=0.740).There was no difference in pRNFL between the two groups(P=0.102).There were no differences in RPC density in whole image(P=0.826)and peripapillary region(P=0.923),but inside disc RPC density was higher in crowded optic discs(P=0.003).The PPCMv density in the inner-hemisuperior region was also lower in crowded discs(P=0.026).The pRNFL thickness was positively correlated with peripapillary RPC density(r=0.498,P<0.001).The inside disc RPC density was negatively correlated with c/d area ratio(r=-0.341,P=0.002).CONCLUSION:The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.展开更多
AIM:To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson’s disease(PD)using optical coherence tomography angiography(OCT-A).METHODS:A retrospective study of...AIM:To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson’s disease(PD)using optical coherence tomography angiography(OCT-A).METHODS:A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens,“Georgios Gennimatas”from March 2021 to March 2022 was conducted.Totally 44 patients with PD were included and 18 healthy controls were examined,hence a total of 124 eyes were enrolled in the study.The foveal and parafoveal superficial and deep capillary plexus vascular density(fSCP-VD,fDCP-VD,pSCP-VD,pDCP-CD)and foveal avascular zone(FAZ)were quantified with OCTA.Optical coherence tomography(OCT)was used to measure macular thickness.Our statistical analysis was conducted by using a mixed effect linear regression model.RESULTS:After adjustment for age and gender,the mean parafoveal superficial capillary plexus vascular density(pSCP-VD)and mean parafoveal deep capillary plexus vascular density(pDCP-VD)were significantly decreased in individuals with PD(P<0.001 in both)by-2.35(95%CI-3.3,-1.45)and-7.5(95%CI-10.4,-4.6)respectively.fSCP-VD and fDCP-VD didn’t approach statistical significance.The FAZ area and perimeter were significantly decreased(P<0.001 in both)by-0.1 mm^(2)(95%CI-0.13,-0.07)and-0.49 mm^(2)(95%CI-0.66,-0.32)respectively.Circularity didn’t approach statistical significance.Central retinal thickness(CRT)was significantly decreased in individuals with PD(P<0.001)by-23.1μm(95%CI-30.2,-16)and temporal retinal thickness(TRT)was decreased(P=0.025)by-11μm(95%CI-22,-1.5)while nasal retinal thickness(NRT)only approached statistical significance(P=0.066).CONCLUSION:The mean pSCP-VD,pDCP-VD,CRT and TRT are significantly decreased and FAZ is altered in individuals with PD.These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.展开更多
AIM:To investigate the aqueous vein in vivo by using enhanced depth imaging optical coherence tomography(EDI-OCT)and optical coherence tomography angiography(OCTA).METHODS:In this cross-sectional comparative study,30 ...AIM:To investigate the aqueous vein in vivo by using enhanced depth imaging optical coherence tomography(EDI-OCT)and optical coherence tomography angiography(OCTA).METHODS:In this cross-sectional comparative study,30 healthy participants were enrolled.Images of the aqueous and conjunctival veins were captured by EDI-OCT and OCTA before and after water loading.The area,height,width,location depth and blood flow of the aqueous vein and conjunctival vein were measured by Image J software.RESULTS:In the static state,the area of the aqueous vein was 8166.7±3272.7μm^(2),which was smaller than that of the conjunctival vein(13690±7457μm^(2),P<0.001).The mean blood flow density of the aqueous vein was 35.3%±12.6%,which was significantly less than that of the conjunctival vein(51.5%±10.6%,P<0.001).After water loading,the area of the aqueous vein decreased significantly from 8725.8±779.4μm^(2)(baseline)to 7005.2±566.2μm^(2)at 45min but rose to 7863.0±703.2μm^(2)at 60min(P=0.032).The blood flow density of the aqueous vein decreased significantly from 41.2%±4.5%(baseline)to 35.4%±3.2%at 30min but returned to 45.6%±3.6%at 60min(P=0.021).CONCLUSION:The structure and blood flow density of the aqueous vein can be effectively evaluated by OCT and OCTA.These may become biological indicators to evaluate aqueous vein changes and aqueous outflow resistance under different interventions in glaucoma patients.展开更多
·AIM:To evaluate optic nerve head(ONH)vessel density(VD)changes after cataract surgery using optical coherence tomography angiography(OCTA).·METHODS:This was a prospective observational study.Thirty-four eye...·AIM:To evaluate optic nerve head(ONH)vessel density(VD)changes after cataract surgery using optical coherence tomography angiography(OCTA).·METHODS:This was a prospective observational study.Thirty-four eyes with mild/moderate cataracts were included.ONH scans were obtained before and 3mo after cataract surgery using OCTA.Radial peripapillary capillary(RPC)density,all VD,large VD and retinal nerve fiber layer thickness(RNFLT)in total disc,inside disc,and different peripapillary sectors were assessed and analyzed.Image quality score(QS),fundus photography grading and bestcorrected visual acuity(BCVA)were also collected,and correlation analyses were performed between VD change and these parameters.·RESULTS:Compared with baseline,both RPC and all VD increased in inside disc area 3mo postoperatively(from 47.5%±5.3%to 50.2%±3.7%,and from 57.87%±4.30%to 60.47%±3.10%,all P<0.001),but no differences were observed in peripapillary area.However,large VD increased from 5.63%±0.77%to 6.47%±0.72%in peripapillary ONH region(P<0.001).RPC decreased in inferior and superior peripapillary ONH parts(P=0.019,<0.001 respectively).There were obvious negative correlations between RPC change and large VD change in inside disc,superior-hemi,and inferior-hemi(r=-0.419,-0.370,and-0.439,P=0.017,0.044,and 0.015,respectively).No correlations were found between VD change and other parameters including QS change,fundus photography grading,postoperative BCVA,and postoperative peripapillary RNFLT.·CONCLUSION:RPC density and all VD in the inside disc ONH region increase 3mo after surgery in patients with mild to moderate cataract.No obvious VD changes are found in peripapillary area postoperatively.展开更多
AIM:To explore the effect of orthokeratology(OK)fitting on retinal vessel density in low to moderate myopia adolescents by using optical coherence tomography angiography.METHODS:Children aged 10 to 14y with a cyclople...AIM:To explore the effect of orthokeratology(OK)fitting on retinal vessel density in low to moderate myopia adolescents by using optical coherence tomography angiography.METHODS:Children aged 10 to 14y with a cycloplegic spherical equivalent refraction of−0.50 diopter(D)to−5.00 D and astigmatism with more than−1.50 D were recruited.The enrolled adolescents were divided into OK group and spectacle group.During regular followup,adolescents were measured respectively at pre-wear,1,3,and 6mo after treatment.The follow-up included uncorrected distance visual acuity(UDVA),axial length(AL),superficial capillary plexus density(SCPD),deep capillary plexus density(DCPD),central retinal thickness(CRT),foveal avascular zone area(FAZ-A),foveal avascular zone perimeter(FAZ-P)and foveal vessel density in a 300-μmwide region around foveal avascular zone(FD-300).The collected data were analyzed using statistical methods.RESULTS:By one month,SCPD significantly increased in the fovea and superior retina,and DCPD significantly increased inferiorly in OK group compared to spectacle group(P<0.05).By three months,there were significant increases in SCPD in the fovea and inferior retina,and DCPD in the parafovea,superior,and inferior retina in OK group(P<0.05),while the increase in SCPD and DCPD in the fovea were observed by six months(P<0.05).The FD-300 significantly increased at every follow-up in OK group compared to spectacle group(P<0.05).No significant differences in the CRT,FAZ-A and FAZ-P and FD-300 were observed between two groups(P>0.05).OK group showed a significant improvement in UDVA after wearing OK,compared to spectacle group(P<0.01),while the AL did not show a significant difference between two groups(P>0.05).CONCLUSION:Short-term OK worn can increase local retinal vessel density in adolescents with low-to-moderate myopia.展开更多
AIM:To evaluate the predicative factors of visual prognosis using optical coherence tomography angiography(OCTA)in ischemic branch retinal vein occlusion(BRVO)patients with macular edema(ME)after anti-vascular endothe...AIM:To evaluate the predicative factors of visual prognosis using optical coherence tomography angiography(OCTA)in ischemic branch retinal vein occlusion(BRVO)patients with macular edema(ME)after anti-vascular endothelial growth factor(VEGF)treatment.METHODS:In this retrospective analysis,data from 60 patients(60 eyes)with a definite diagnosis of ischemic BRVO with ME by fundus fluorescein angiography(FFA)were studied.The eyes with ME according to spectral domain optical coherence tomography(SD-OCT)underwent intravitreal conbercept(IVC)and 3+pro re nata(PRN)regimen.The injection times were recorded.Two weeks after injection,fundus laser photocoagulation was performed in the non-perfusion area of the retina.The patients were followed up once a month for 6mo.The bestcorrected visual acuity(BCVA),foveal avascular zone(FAZ),and A-circularity index(AI),at 6mo and the baseline were compared.RESULTS:All patients showed significant improvement in BCVA from 0.82±0.32 to 0.39±0.11 logMAR(P<0.001).The mean central macular thickness(CMT)significantly decreased from 476.22±163.54 to 298.66±109.23μm.Both the FAZ area and AI at 6mo were significantly higher than those at the baseline:the FAZ area increased(0.38±0.02 vs 0.39±0.02 mm^(2),P<0.05);the AI increased(1.27±0.02 vs 1.31±0.01,P=0.000).The baseline BCVA showed a significantly positive correlation with the baseline FAZ area,FAZ perimeter(PERIM)and AI,final visual gain(FVG)and injection times,respectively(P<0.001).FVG showed a significantly negative correlation with the FAZ area,PERIM,AI and injection times,but a significantly positive correlation with vessel densities(VDs)300μm area around FAZ(FD-300;P<0.001).Injection times was positively correlated with the baseline FAZ area,and AI,but inversely correlated with the baseline FD-300(P<0.001).However macular ischemia was noted in 5 cases during follow-up.CONCLUSION:Using OCTA to observe macular ischemia and quantify parameters can better predict the final visual prognosis of patients before treatment.The changes in FAZ parameters may influence the visual prognosis and injection times.展开更多
AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)...AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)and compare them with healthy control subjects.METHODS:In this prospective,cross-sectional study,a total of 165 eyes were evaluated,including 50 eyes of patients with diabetic ERM,54 eyes of idiopathic ERM(iERM)patients,and 61 eyes of healthy controls.Macula and disc angiography was performed by OCT-A.Macular vessel density(VD)ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region.Statistical calculations were evaluated at the 95%confidence interval.RESULTS:Macula superficial VD values of ERM cases were lower than that in the control group,while foveal VD was higher in ERM cases.Macula deep VD values of ERM cases were lower in all quadrants,except the fovea.The width of the foveal avascular zone(FAZ)area was significantly lower in the ERM groups,and the FAZ width was lowest in iERM group.Macula superficial VD ratio was significantly higher in the ERM groups,but there was no significant difference between ERM groups.Macula deep VD ratio was significantly higher in the iERM group than in the control group.CONCLUSION:Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation,as well as their effect on retinal vascular structures.If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A,then,OCT-A can be used as a guide for ERM prognosis.展开更多
AIM:To describe the optical coherence tomography angiography(OCTA)characteristics of exudative and nonexudative treatment-naïve pachychoroid neovasculopathy(PNV).METHODS:Thirty-five patients with exudative treatm...AIM:To describe the optical coherence tomography angiography(OCTA)characteristics of exudative and nonexudative treatment-naïve pachychoroid neovasculopathy(PNV).METHODS:Thirty-five patients with exudative treatmentnaïve PNV and 13 with non-exudative treatment-naïve PNV between March 2020 and December 2021 were included.All patients underwent ophthalmologic examination,including fluorescein angiography(FA),indocyanine green angiography(ICGA),spectral-domain OCT,and OCTA.The clinical data of the patients were retrospectively analyzed.RESULTS:The study included 51 eyes from 46 patients,of whom 33(71.7%)were male.The central macular thickness(CMT)in the exudative PNV group was significantly higher than that in the non-exudative PNV group(383.97±132.16μm vs 213.13±51.63μm;P<0.001).The maximum height of flat irregular pigment epithelial detachments(FIPED)was 45.40±11.86μm in the non-exudative PNV group,significantly lower than the 71.58±20.91μm(P<0.001)in the exudative PNV group.The area of PNV of the non-exudative PNV group was,significantly larger than that of the exudative PNV group(1.06±0.84 mm2 vs 0.63±0.80 mm2,P=0.016).There was a significant difference in PNV morphology between the two groups(P<0.001).Multivariate logistic regression analysis found that the maximum height of FIPED(OR=1.156,95%CI:1.019-1.312;P=0.024)and microvascular branches(OR=69.412,95%CI:3.538-1361.844;P=0.005)were independent predictors of PNV activity.CONCLUSION:The OCTA imaging finds that there are significant differences in CMT,maximum height of FIPED,PNV area,and morphology of exudative PNV and non-exudative PNV groups.OCTA can accurately identify the clinical and imaging features of exudative and nonexudative treatment-naïve PNV,and distinguish PNV activity.展开更多
AIM:To investigate foveal avascular zone(FAZ) and parafoveal vessel densities(PRVD) by means of optical coherence tomography angiography(OCTA) in diabetic patients with or without diabetic retinopathy(DR) and to asses...AIM:To investigate foveal avascular zone(FAZ) and parafoveal vessel densities(PRVD) by means of optical coherence tomography angiography(OCTA) in diabetic patients with or without diabetic retinopathy(DR) and to assess the reproducibility of FAZ and PRVD measurements.METHODS:Sixty diabetic patients(60 eyes) with different stage of DR(graded according to the International Clinical Severity Scale for DR) and 20 healthy subjects underwent FAZ area and PRVD measurements using OCTA by two experienced examiners.FAZ area in all patients was also assessed using fluorescein angiography(FA).RESULTS:In subject with proliferative DR and with moderate-severe non proliferative DR,FAZ area was significantly increased compared to healthy controls(P=0.025 and P=0.050 respectively measured with OCTA and P=0.025 and P=0.048 respectively measured with FA).OCTA showed significantly less inter-observer variability compared to FA.Concordance correlation coefficient(CCC) for FAZ area measurements was 0.829(95%CI:0.736-0.891) P<0.001 with FA and 1.000(95%CI:0.999-1.000) P<0.001 with OCTA.CCC was 0.834(95%CI:0.746-0.893) P<0.001 and 0.890(95%CI:0.828-0.930) P<0.001 for parafoveal superficial and deep vessel density measurements,respectively.CONCLUSION:OCTA shows progressive increase of FAZ area and reduction of PRVD in both superficial and deep plexus at increasing DR severity.FAZ area and PRVD measurements using OCTA are highly reproducible.展开更多
AIM: To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy(NAION) eyes with normal eyes. METHODS: The optic disc blood flow densities of diagnosed non-acute phase NAION eyes(21 eyes, 14 indiv...AIM: To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy(NAION) eyes with normal eyes. METHODS: The optic disc blood flow densities of diagnosed non-acute phase NAION eyes(21 eyes, 14 individuals) and normal eyes(19 eyes, 12 individuals) were detected via Optovue optical coherence tomography angiography(OCTA). The optic disc blood flow was measured via Image J software. Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis.RESULTS: The average percentage of the optic disc nonperfusion areas in the non-acute phase NAION patients(17.84%±6.18%) was increased, when compared to the normal control eyes(8.61%±1.65%), and the difference was statistically significant(P<0.01). Moreover, there was a proportional correlation between the visual field mean defect(MD) and the optic disc non-perfusion area percentage, and the relationship was statistically significant(t=3.65, P<0.01, R^2=0.4118). In addition, the critical correlation between the best corrected visual acuity(BCVA) and the optic disc non-perfusion area percentage was statistically significant(t=4.32, P<0.01, R^2=0.4957).CONCLUSION: The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes. Both the BCVA and MD were correlated with the optic disc flow detected, revealing that OCTA may be valuable in the diagnosis and estimation of NAION.展开更多
AIM: To evaluate foveal vessel density(VD) and foveal thickness using optical coherence tomography angiography(OCTA) in retinopathy of prematurity(ROP) children treated with laser photocoagulation or anti-vascular end...AIM: To evaluate foveal vessel density(VD) and foveal thickness using optical coherence tomography angiography(OCTA) in retinopathy of prematurity(ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor(VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children.METHODS: This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes(14 patients) treated with anti-VEGF injection and twentynine eyes(17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina(centered on the fovea) using OCTA and cross-sectional OCT, respectively.RESULTS: Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation(P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina(P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group(P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study.CONCLUSION: In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70 mo after the treatments.展开更多
AIM:To evaluate and compare the peripapillary and retinal vasculature changes in primary open angle glaucoma(POAG),pseudoexfoliation glaucoma(PXG),ocular hypertension(OHT)and normal eyes using optical coherence tomogr...AIM:To evaluate and compare the peripapillary and retinal vasculature changes in primary open angle glaucoma(POAG),pseudoexfoliation glaucoma(PXG),ocular hypertension(OHT)and normal eyes using optical coherence tomography angiography(OCTA).METHODS:A total of 114 POAG,PXG and OHT eyes of 60 patients and 46 eyes of 23 healthy control participants with good quality OCTA images were included.The PXG,POAG,OHT,and control groups(aged 68.17±6.30 y,61.11±10.26 y,58.1±8.9 y,and 56.9±4.6 y,respectively)contained of 46,36,32,and 46 eyes,respectively.Measurements of vessel density(VD)in the peripapillary region and macula,average retinal inner thickness,and retinal nerve fiber layer thickness(RNFLT)were compared among groups.In order to test the accuracy of differentiation between eyes with and without glaucoma,the area was calculated under the receiver operating characteristic(ROC)curves.RESULTS:The VD in glaucomatous eyes was significantly lower than the control group in all peripapillary sectors(44.35%±6.78%vs 50.47%±1.83%,P<0.001),the superficial(44.08%±5.46%vs 51.28%±2.85%,P<0.001)and the deep(45.13%±8.55%vs 54.20%±5.44%,P<0.001)vascular plexus.There was a significant difference in peripapillary VD between glaucomatous and OHT eyes(44.35%±6.78%vs 49.86%±2.45%,P<0.001).The OHT group featured a lower superficial(48.06%±4.32%vs 51.28%±2.85%,P=0.027)and deep plexus(48.70%±5.99%vs 54.20%±5.44%,P=0.013)whole image vessel density(wiVD)than did the control group.The average macular superficial plexus wiVD was significantly lower in eyes with PXG than in eyes with POAG(42.22%±5.36%vs 46.54%±5.56%,P=0.046).CONCLUSION:OCTA can measure reduced peripapillary and macular VD in eyes with glaucoma and OHT,and these results are correlated to functional and structural glaucomatous alterations.Peripapillary and macular superficial plexus VD is lower in eyes with PXG than in eyes with POAG.Furthermore,the OHT eyes demonstrate impaired macular vasculature in both superficial and deep plexus.展开更多
AIM:To quantitatively evaluate the effect of the combined use of 577-nm subthreshold micropulse macular laser(SML)and multi-point mode pan retinal laser photocoagulation(PRP)on severe non-proliferative diabetic retino...AIM:To quantitatively evaluate the effect of the combined use of 577-nm subthreshold micropulse macular laser(SML)and multi-point mode pan retinal laser photocoagulation(PRP)on severe non-proliferative diabetic retinopathy(NPDR)with central-involved diabetic macular edema(CIDME)using optical coherence tomography angiography(OCTA).METHODS:In this observational clinical study,86 eyes of 86 NPDR patients with CIDME who underwent SML and PRP treatment were included.Images were obtained 1 d before laser and post-laser(1 d,1 wk,1,3,and 6 mo)using AngioV ue software 2.0.Best corrected visual acuity(BCVA,LogM AR),foveal avascular zone area(FAZ),choriocapillary flow area(Ch F),parafoveal vessel density(PVD),capillary density inside disc(CDD),peripapillary capillary density(PCD),macular ganglion cell complex thickness(m GCCT),central macular thickness(CMT),and subfoveal choroidal thickness(ChT)were compared between pre-and post-laser treatment.RESULTS:BCVA remained stable during 6 mo postlaser therapy(pre-laser vs 6 mo post-laser:0.53±0.21 vs 0.5±0.15,P>0.05).PVD,ChF,ChT,CMT,and mGCCT significantly increased 1 d post-laser therapy[pre-laser vs 1 d post-laser:superficial PVD(%),40.51±3.42 vs 42.43±4.68;deep PVD(%),42.66±3.67 vs 44.78±4.52;ChF,1.72±0.21 vs 1.9±0.12 mm^2;ChT,302.45±69.74 vs 319.38±70.93μm;CMT,301.65±110.78 vs 320.86±105.62μm;m GCCT,105.71±10.72 vs 115.46±9.64μm;P<0.05].However,PVD,ChF and ChT decreased to less than baseline level at 6 mo postlaser therapy(pre-laser vs 6 mo post-laser:superficial PVD(%),40.51±3.42 vs 36.32±4.19;deep PVD(%),42.66±3.67 vs 38.76±3.74;Ch F,1.72±0.21 vs 1.62±0.09 mm^2;Ch T,302.45±69.74 vs 289.61±67.55μm;P<0.05),whereas CMT and mG CCT decreased to baseline level at 6 mo postlaser therapy(CMT,301.65±110.78 vs 297.77±90.23μm;m GCCT,105.71±10.72 vs 107.05±11.81μm;P>0.05).Moreover,FAZ continuously increased while CDD and PCD continuously decreased in 6 mo after laser therapy.CMT and ChT had a significant positive correlation with ChF and PVD in most post-laser stages.CONCLUSION:During a 6-month follow-up period after combined use of SML and PRP therapy,BCVA remained stable and there was a decreased trend in macular edema.Blood flow increased at 1 d post-laser therapy and reduced at 6 mo post-laser therapy.展开更多
AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and...AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and to explore changes in retinal function.METHODS:Twenty-nine patients with ATD and 26 age-matched normal subjects were enrolled.All subjects underwent OCTA scans to analyse the superficial retinal vessel parameters in the macular area,including the vessel length density,the vessel perfusion density and the area of foveal avascular zone(FAZ),as well as the choroidal thickness.The differences between the patients with ATD and the normal control group were compared and explored the relevant factors affecting vessel parameters.We also recorded the flash ERGs using the RETeval system and intended to explore changes in retinal function by analysing the ERG image amplitude in patients with ATD.RESULTS:The vessel parameters[Pvessel length density=0.005 and Pvessel perfusion density=0.006]and average choroid thickness(P<0.001)in the macular area of the ATD group was less than the control group.The FAZ area was statistically significantly enlarged in the ATD group(P<0.001).These parameters were correlated with the Mini-Mental State Examination(MMSE)score and the Montreal Cognitive Assessment(MoCA).CONCLUSION:Patients with ATD exhibit decreases in the parameters associated with fundus.In addition,these indicators significantly correlate with the MMSE score and the MoCA score.OCTA may be an adjunct tool with strong potential to track changes in the diagnosis and monitoring the progression of the disease.展开更多
AIM: To compare the clinical performance of 4 spectraldomain(SD) optical coherence tomography angiography(OCTA) systems: AngioVueTM, AngioPlexTM, Spectralis? OCTA, AngioScan, and 1 swept-source(SS) OCTA SS OCT AngioTM...AIM: To compare the clinical performance of 4 spectraldomain(SD) optical coherence tomography angiography(OCTA) systems: AngioVueTM, AngioPlexTM, Spectralis? OCTA, AngioScan, and 1 swept-source(SS) OCTA SS OCT AngioTM. METHODS: Twenty-seven undilated right eyes of 27 participants underwent OCTA examination using five different systems respectively for both 3×3 and 6×6 mm2 scan pattern(Spectralis OCTA for 3×3 mm2 scan only). Image quality, including vessel valid visibility and the number of motion artifacts, and acquisition time were evaluated. Repeated measures analysis of variance(ANOVA) with Bonferroni's post-test and Friedman test with Dunn's posttest were used to compare measurements.RESULTS: The age of the subjects was 28.19±5.55 y(range, 23-49 y). The spherical equivalent refraction was-2.55±1.84 D(range, 0.00 to-5.25 D). Significant difference was observed in the evaluation of vessel valid visibility(Angio Vue the highest: 0.111±0.031 for 3×3 mm2 scan and 0.128±0.020 for 6×6 mm2 scan), number of motion artifacts(AngioVue the fewest: 0.778±1.086 for 3×3 mm2 scan and 0.333±0.620 for 6×6 mm2 scan) and acquisition time(AngioPlex the shortest: 8.537±1.921 s for 3×3 mm2 scan and 8.298±1.741 s for 6×6 mm2 scan; all P<0.001). CONCLUSION: There is poor agreement of measurements among systems. AngioVue provides images with the highest vessel valid visibility and the fewest motion artifacts. AngioPlex achieves the shortest acquisition.展开更多
AIM:To quantitatively detect aqueous levels of angiopoietin-like(ANGPTL)3,ANGPTL4,and ANGPTL6 and investigate their correlation with optical coherence tomography angiography(OCTA)findings in patients with diabetic mac...AIM:To quantitatively detect aqueous levels of angiopoietin-like(ANGPTL)3,ANGPTL4,and ANGPTL6 and investigate their correlation with optical coherence tomography angiography(OCTA)findings in patients with diabetic macular edema(DME).METHODS:This cross-sectional study included 23 patients(27 eyes)with type 2 diabetes and 16 control subjects(20 eyes).All patients underwent OCTA imaging and ultra-wide field fundus photography.Diabetic patients were categorized into two groups according to the presence or absence of diabetic retinopathy(DME group,14 patients,16 eyes);and non-diabetic retinopathy(NDR)group,9 patients,11 eyes,respectively.Aqueous levels of ANGPTL3,ANGPTL4,and ANGPTL6 were assessed using suspension array technology,and foveal-centered 3×3 mm2 OCTA scans were automatically graded to determine the central,inner,and full vessel density(CVD,IVD,FVD);central,inner,and full perfusion density(CPD,IPD,FPD),foveal avascular zone(FAZ)area,FAZ perimeter,and FAZ circularity index(FAZ-CI)on superficial capillary plexuses.Additionally,central subfield thickness(CST),cube volume(CV),and cube average thickness(CAT)were measured in a model of macular cube 512×128.RESULTS:Aqueous ANGPTL3 levels were not significantly different among the three groups(P>0.05).ANGPTL4 levels were significantly higher in the DME group than the control and NDR groups(P<0.0001 and P<0.001),while ANGPTL6 levels were significantly higher in the DME group than the control group(P<0.05).In the whole cohort,the aqueous ANGPTL3 levels correlated negatively with the IVD,FVD,IPD,and FPD,and positively with the CV and CAT.The aqueous ANGPTL4 levels correlated negatively with the CVD,IVD,FVD,CPD,IPD,and FPD,and positively with the FAZ perimeter,CST,CV,and CAT.The aqueous ANGPTL6 levels correlated negatively with the IVD,FVD,IPD,FPD,FAZCI and positively with CST,CV,CAT.CONCLUSION:ANGPTL4 and ANGPTL6 may be associated with vascular leakage in DME and may represent good targets for DME therapy.In addition,OCTA metrics may be useful for evaluating macular ischemia in DME.展开更多
Retinitis pigmentosa(RP)is the most recognized inherited retinal disorder involving progressive photoreceptors degeneration which eventually causes blindness.However,the pathogenesis of RP is still unclear,making it d...Retinitis pigmentosa(RP)is the most recognized inherited retinal disorder involving progressive photoreceptors degeneration which eventually causes blindness.However,the pathogenesis of RP is still unclear,making it difficult to establish satisfying treatments.Evidence have been found to support the theory that vascular dysfunction is associated with the progression of RP.Optical coherence tomography angiography(OCTA)is a newly developed technology that enables visualization as well as quantitative assessment of retinal and choroidal vasculature noninvasively.Advances in OCTA have opened a window for indepth understanding of RP pathogenesis.Here,we propose a hypothesis of RP pathogenesis based on the current OCTA findings in RP,which includes four stages and two important key factors,vascular dysfunction and microglia activation.Further,we discuss the future animal experiments needed and how advanced OCTA technology can help to further verity the hypothesis.The final goal is to explore potential treatment options with enhanced understanding of RP pathogenesis.展开更多
文摘AIM:To evaluate the predictive value of superficial retinal capillary plexus(SRCP)and radial peripapillary capillary(RPC)for visual field recovery after optic cross decompression and compare them with peripapillary nerve fiber layer(pRNFL)and ganglion cell complex(GCC).METHODS:This prospective longitudinal observational study included patients with chiasmal compression due to sellar region mass scheduled for decompressive surgery.Generalized estimating equations were used to compare retinal vessel density and retinal layer thickness preand post-operatively and with healthy controls.Logistic regression models were used to assess the relationship between preoperative GCC,pRNFL,SRCP,and RPC parameters and visual field recovery after surgery.RESULTS:The study included 43 eyes of 24 patients and 48 eyes of 24 healthy controls.Preoperative RPC and SRCP vessel density and pRNFL and GCC thickness were lower than healthy controls and higher than postoperative values.The best predictive GCC and pRNFL models were based on the superior GCC[area under the curve(AUC)=0.866]and the tempo-inferior pRNFL(AUC=0.824),and the best predictive SRCP and RPC models were based on the nasal SRCP(AUC=0.718)and tempo-inferior RPC(AUC=0.825).There was no statistical difference in the predictive value of the superior GCC,tempo-inferior pRNFL,and tempo-inferior RPC(all P>0.05).CONCLUSION:Compression of the optic chiasm by tumors in the saddle area can reduce retinal thickness and blood perfusion.This reduction persists despite the recovery of the visual field after decompression surgery.GCC,pRNFL,and RPC can be used as sensitive predictors of visual field recovery after decompression surgery.
文摘AIM:To compare superficial and deep vascular properties of optic discs between crowded discs and controls using optical coherence tomography angiography(OCT-A).METHODS:Thirty patients with crowded discs,and 47 control subjects were enrolled in the study.One eye of each individual was included and OCT-A scans of optic discs were obtained in a 4.5×4.5 mm^(2) rectangular area.Radial peripapillary capillary(RPC)density,peripapillary retinal nerve fiber layer(pRNFL)thickness,cup volume,rim area,disc area,cup-to-disc(c/d)area ratio,and vertical c/d ratio were obtained automatically using device software.Automated parapapillary choroidal microvasculature(PPCMv)density was calculated using MATLAB software.When the vertical c/d ratio of the optic disc was absent or small cup,it was considered as a crowded disc.RESULTS:The mean signal strength index of OCT-A images was similar between the crowded discs and control eyes(P=0.740).There was no difference in pRNFL between the two groups(P=0.102).There were no differences in RPC density in whole image(P=0.826)and peripapillary region(P=0.923),but inside disc RPC density was higher in crowded optic discs(P=0.003).The PPCMv density in the inner-hemisuperior region was also lower in crowded discs(P=0.026).The pRNFL thickness was positively correlated with peripapillary RPC density(r=0.498,P<0.001).The inside disc RPC density was negatively correlated with c/d area ratio(r=-0.341,P=0.002).CONCLUSION:The higher inside disc RPC density and lower inner-hemisuperior PPCMv density are found in eyes with crowded optic discs.
文摘AIM:To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson’s disease(PD)using optical coherence tomography angiography(OCT-A).METHODS:A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens,“Georgios Gennimatas”from March 2021 to March 2022 was conducted.Totally 44 patients with PD were included and 18 healthy controls were examined,hence a total of 124 eyes were enrolled in the study.The foveal and parafoveal superficial and deep capillary plexus vascular density(fSCP-VD,fDCP-VD,pSCP-VD,pDCP-CD)and foveal avascular zone(FAZ)were quantified with OCTA.Optical coherence tomography(OCT)was used to measure macular thickness.Our statistical analysis was conducted by using a mixed effect linear regression model.RESULTS:After adjustment for age and gender,the mean parafoveal superficial capillary plexus vascular density(pSCP-VD)and mean parafoveal deep capillary plexus vascular density(pDCP-VD)were significantly decreased in individuals with PD(P<0.001 in both)by-2.35(95%CI-3.3,-1.45)and-7.5(95%CI-10.4,-4.6)respectively.fSCP-VD and fDCP-VD didn’t approach statistical significance.The FAZ area and perimeter were significantly decreased(P<0.001 in both)by-0.1 mm^(2)(95%CI-0.13,-0.07)and-0.49 mm^(2)(95%CI-0.66,-0.32)respectively.Circularity didn’t approach statistical significance.Central retinal thickness(CRT)was significantly decreased in individuals with PD(P<0.001)by-23.1μm(95%CI-30.2,-16)and temporal retinal thickness(TRT)was decreased(P=0.025)by-11μm(95%CI-22,-1.5)while nasal retinal thickness(NRT)only approached statistical significance(P=0.066).CONCLUSION:The mean pSCP-VD,pDCP-VD,CRT and TRT are significantly decreased and FAZ is altered in individuals with PD.These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.
文摘AIM:To investigate the aqueous vein in vivo by using enhanced depth imaging optical coherence tomography(EDI-OCT)and optical coherence tomography angiography(OCTA).METHODS:In this cross-sectional comparative study,30 healthy participants were enrolled.Images of the aqueous and conjunctival veins were captured by EDI-OCT and OCTA before and after water loading.The area,height,width,location depth and blood flow of the aqueous vein and conjunctival vein were measured by Image J software.RESULTS:In the static state,the area of the aqueous vein was 8166.7±3272.7μm^(2),which was smaller than that of the conjunctival vein(13690±7457μm^(2),P<0.001).The mean blood flow density of the aqueous vein was 35.3%±12.6%,which was significantly less than that of the conjunctival vein(51.5%±10.6%,P<0.001).After water loading,the area of the aqueous vein decreased significantly from 8725.8±779.4μm^(2)(baseline)to 7005.2±566.2μm^(2)at 45min but rose to 7863.0±703.2μm^(2)at 60min(P=0.032).The blood flow density of the aqueous vein decreased significantly from 41.2%±4.5%(baseline)to 35.4%±3.2%at 30min but returned to 45.6%±3.6%at 60min(P=0.021).CONCLUSION:The structure and blood flow density of the aqueous vein can be effectively evaluated by OCT and OCTA.These may become biological indicators to evaluate aqueous vein changes and aqueous outflow resistance under different interventions in glaucoma patients.
基金Supported by Natural Science Foundation of Zhejiang Province (No.LQ19H120001)。
文摘·AIM:To evaluate optic nerve head(ONH)vessel density(VD)changes after cataract surgery using optical coherence tomography angiography(OCTA).·METHODS:This was a prospective observational study.Thirty-four eyes with mild/moderate cataracts were included.ONH scans were obtained before and 3mo after cataract surgery using OCTA.Radial peripapillary capillary(RPC)density,all VD,large VD and retinal nerve fiber layer thickness(RNFLT)in total disc,inside disc,and different peripapillary sectors were assessed and analyzed.Image quality score(QS),fundus photography grading and bestcorrected visual acuity(BCVA)were also collected,and correlation analyses were performed between VD change and these parameters.·RESULTS:Compared with baseline,both RPC and all VD increased in inside disc area 3mo postoperatively(from 47.5%±5.3%to 50.2%±3.7%,and from 57.87%±4.30%to 60.47%±3.10%,all P<0.001),but no differences were observed in peripapillary area.However,large VD increased from 5.63%±0.77%to 6.47%±0.72%in peripapillary ONH region(P<0.001).RPC decreased in inferior and superior peripapillary ONH parts(P=0.019,<0.001 respectively).There were obvious negative correlations between RPC change and large VD change in inside disc,superior-hemi,and inferior-hemi(r=-0.419,-0.370,and-0.439,P=0.017,0.044,and 0.015,respectively).No correlations were found between VD change and other parameters including QS change,fundus photography grading,postoperative BCVA,and postoperative peripapillary RNFLT.·CONCLUSION:RPC density and all VD in the inside disc ONH region increase 3mo after surgery in patients with mild to moderate cataract.No obvious VD changes are found in peripapillary area postoperatively.
基金Supported by Medical Research Fund of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Medical Group.
文摘AIM:To explore the effect of orthokeratology(OK)fitting on retinal vessel density in low to moderate myopia adolescents by using optical coherence tomography angiography.METHODS:Children aged 10 to 14y with a cycloplegic spherical equivalent refraction of−0.50 diopter(D)to−5.00 D and astigmatism with more than−1.50 D were recruited.The enrolled adolescents were divided into OK group and spectacle group.During regular followup,adolescents were measured respectively at pre-wear,1,3,and 6mo after treatment.The follow-up included uncorrected distance visual acuity(UDVA),axial length(AL),superficial capillary plexus density(SCPD),deep capillary plexus density(DCPD),central retinal thickness(CRT),foveal avascular zone area(FAZ-A),foveal avascular zone perimeter(FAZ-P)and foveal vessel density in a 300-μmwide region around foveal avascular zone(FD-300).The collected data were analyzed using statistical methods.RESULTS:By one month,SCPD significantly increased in the fovea and superior retina,and DCPD significantly increased inferiorly in OK group compared to spectacle group(P<0.05).By three months,there were significant increases in SCPD in the fovea and inferior retina,and DCPD in the parafovea,superior,and inferior retina in OK group(P<0.05),while the increase in SCPD and DCPD in the fovea were observed by six months(P<0.05).The FD-300 significantly increased at every follow-up in OK group compared to spectacle group(P<0.05).No significant differences in the CRT,FAZ-A and FAZ-P and FD-300 were observed between two groups(P>0.05).OK group showed a significant improvement in UDVA after wearing OK,compared to spectacle group(P<0.01),while the AL did not show a significant difference between two groups(P>0.05).CONCLUSION:Short-term OK worn can increase local retinal vessel density in adolescents with low-to-moderate myopia.
文摘AIM:To evaluate the predicative factors of visual prognosis using optical coherence tomography angiography(OCTA)in ischemic branch retinal vein occlusion(BRVO)patients with macular edema(ME)after anti-vascular endothelial growth factor(VEGF)treatment.METHODS:In this retrospective analysis,data from 60 patients(60 eyes)with a definite diagnosis of ischemic BRVO with ME by fundus fluorescein angiography(FFA)were studied.The eyes with ME according to spectral domain optical coherence tomography(SD-OCT)underwent intravitreal conbercept(IVC)and 3+pro re nata(PRN)regimen.The injection times were recorded.Two weeks after injection,fundus laser photocoagulation was performed in the non-perfusion area of the retina.The patients were followed up once a month for 6mo.The bestcorrected visual acuity(BCVA),foveal avascular zone(FAZ),and A-circularity index(AI),at 6mo and the baseline were compared.RESULTS:All patients showed significant improvement in BCVA from 0.82±0.32 to 0.39±0.11 logMAR(P<0.001).The mean central macular thickness(CMT)significantly decreased from 476.22±163.54 to 298.66±109.23μm.Both the FAZ area and AI at 6mo were significantly higher than those at the baseline:the FAZ area increased(0.38±0.02 vs 0.39±0.02 mm^(2),P<0.05);the AI increased(1.27±0.02 vs 1.31±0.01,P=0.000).The baseline BCVA showed a significantly positive correlation with the baseline FAZ area,FAZ perimeter(PERIM)and AI,final visual gain(FVG)and injection times,respectively(P<0.001).FVG showed a significantly negative correlation with the FAZ area,PERIM,AI and injection times,but a significantly positive correlation with vessel densities(VDs)300μm area around FAZ(FD-300;P<0.001).Injection times was positively correlated with the baseline FAZ area,and AI,but inversely correlated with the baseline FD-300(P<0.001).However macular ischemia was noted in 5 cases during follow-up.CONCLUSION:Using OCTA to observe macular ischemia and quantify parameters can better predict the final visual prognosis of patients before treatment.The changes in FAZ parameters may influence the visual prognosis and injection times.
文摘AIM:To evaluate the retinochoroidal microvascular circulation and anatomical structure of diabetic and nondiabetic patients with epiretinal membrane(ERM)with the help of optical coherence tomography angiography(OCT-A)and compare them with healthy control subjects.METHODS:In this prospective,cross-sectional study,a total of 165 eyes were evaluated,including 50 eyes of patients with diabetic ERM,54 eyes of idiopathic ERM(iERM)patients,and 61 eyes of healthy controls.Macula and disc angiography was performed by OCT-A.Macular vessel density(VD)ratio was evaluated by dividing the VD of the foveal region by the VD of the parafoveal region.Statistical calculations were evaluated at the 95%confidence interval.RESULTS:Macula superficial VD values of ERM cases were lower than that in the control group,while foveal VD was higher in ERM cases.Macula deep VD values of ERM cases were lower in all quadrants,except the fovea.The width of the foveal avascular zone(FAZ)area was significantly lower in the ERM groups,and the FAZ width was lowest in iERM group.Macula superficial VD ratio was significantly higher in the ERM groups,but there was no significant difference between ERM groups.Macula deep VD ratio was significantly higher in the iERM group than in the control group.CONCLUSION:Diabetic and idiopathic ERMs differ in their mechanism of formation and clinical presentation,as well as their effect on retinal vascular structures.If the relationship of increase of retinal thickness with vascular integrity can be demonstrated with OCT-A,then,OCT-A can be used as a guide for ERM prognosis.
基金Supported by the IIT project of“Research and Development Fund of Conbercept”funded by Beijing Bethune Charitable Foundation.
文摘AIM:To describe the optical coherence tomography angiography(OCTA)characteristics of exudative and nonexudative treatment-naïve pachychoroid neovasculopathy(PNV).METHODS:Thirty-five patients with exudative treatmentnaïve PNV and 13 with non-exudative treatment-naïve PNV between March 2020 and December 2021 were included.All patients underwent ophthalmologic examination,including fluorescein angiography(FA),indocyanine green angiography(ICGA),spectral-domain OCT,and OCTA.The clinical data of the patients were retrospectively analyzed.RESULTS:The study included 51 eyes from 46 patients,of whom 33(71.7%)were male.The central macular thickness(CMT)in the exudative PNV group was significantly higher than that in the non-exudative PNV group(383.97±132.16μm vs 213.13±51.63μm;P<0.001).The maximum height of flat irregular pigment epithelial detachments(FIPED)was 45.40±11.86μm in the non-exudative PNV group,significantly lower than the 71.58±20.91μm(P<0.001)in the exudative PNV group.The area of PNV of the non-exudative PNV group was,significantly larger than that of the exudative PNV group(1.06±0.84 mm2 vs 0.63±0.80 mm2,P=0.016).There was a significant difference in PNV morphology between the two groups(P<0.001).Multivariate logistic regression analysis found that the maximum height of FIPED(OR=1.156,95%CI:1.019-1.312;P=0.024)and microvascular branches(OR=69.412,95%CI:3.538-1361.844;P=0.005)were independent predictors of PNV activity.CONCLUSION:The OCTA imaging finds that there are significant differences in CMT,maximum height of FIPED,PNV area,and morphology of exudative PNV and non-exudative PNV groups.OCTA can accurately identify the clinical and imaging features of exudative and nonexudative treatment-naïve PNV,and distinguish PNV activity.
文摘AIM:To investigate foveal avascular zone(FAZ) and parafoveal vessel densities(PRVD) by means of optical coherence tomography angiography(OCTA) in diabetic patients with or without diabetic retinopathy(DR) and to assess the reproducibility of FAZ and PRVD measurements.METHODS:Sixty diabetic patients(60 eyes) with different stage of DR(graded according to the International Clinical Severity Scale for DR) and 20 healthy subjects underwent FAZ area and PRVD measurements using OCTA by two experienced examiners.FAZ area in all patients was also assessed using fluorescein angiography(FA).RESULTS:In subject with proliferative DR and with moderate-severe non proliferative DR,FAZ area was significantly increased compared to healthy controls(P=0.025 and P=0.050 respectively measured with OCTA and P=0.025 and P=0.048 respectively measured with FA).OCTA showed significantly less inter-observer variability compared to FA.Concordance correlation coefficient(CCC) for FAZ area measurements was 0.829(95%CI:0.736-0.891) P<0.001 with FA and 1.000(95%CI:0.999-1.000) P<0.001 with OCTA.CCC was 0.834(95%CI:0.746-0.893) P<0.001 and 0.890(95%CI:0.828-0.930) P<0.001 for parafoveal superficial and deep vessel density measurements,respectively.CONCLUSION:OCTA shows progressive increase of FAZ area and reduction of PRVD in both superficial and deep plexus at increasing DR severity.FAZ area and PRVD measurements using OCTA are highly reproducible.
基金Supported in part by Jiangsu Province’s Outstanding Medical Academic Leader Program (No.CXTDA2017039)the Soochow Scholar Project of Soochow University
文摘AIM: To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy(NAION) eyes with normal eyes. METHODS: The optic disc blood flow densities of diagnosed non-acute phase NAION eyes(21 eyes, 14 individuals) and normal eyes(19 eyes, 12 individuals) were detected via Optovue optical coherence tomography angiography(OCTA). The optic disc blood flow was measured via Image J software. Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis.RESULTS: The average percentage of the optic disc nonperfusion areas in the non-acute phase NAION patients(17.84%±6.18%) was increased, when compared to the normal control eyes(8.61%±1.65%), and the difference was statistically significant(P<0.01). Moreover, there was a proportional correlation between the visual field mean defect(MD) and the optic disc non-perfusion area percentage, and the relationship was statistically significant(t=3.65, P<0.01, R^2=0.4118). In addition, the critical correlation between the best corrected visual acuity(BCVA) and the optic disc non-perfusion area percentage was statistically significant(t=4.32, P<0.01, R^2=0.4957).CONCLUSION: The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes. Both the BCVA and MD were correlated with the optic disc flow detected, revealing that OCTA may be valuable in the diagnosis and estimation of NAION.
文摘AIM: To evaluate foveal vessel density(VD) and foveal thickness using optical coherence tomography angiography(OCTA) in retinopathy of prematurity(ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor(VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children.METHODS: This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes(14 patients) treated with anti-VEGF injection and twentynine eyes(17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina(centered on the fovea) using OCTA and cross-sectional OCT, respectively.RESULTS: Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation(P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina(P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group(P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study.CONCLUSION: In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70 mo after the treatments.
文摘AIM:To evaluate and compare the peripapillary and retinal vasculature changes in primary open angle glaucoma(POAG),pseudoexfoliation glaucoma(PXG),ocular hypertension(OHT)and normal eyes using optical coherence tomography angiography(OCTA).METHODS:A total of 114 POAG,PXG and OHT eyes of 60 patients and 46 eyes of 23 healthy control participants with good quality OCTA images were included.The PXG,POAG,OHT,and control groups(aged 68.17±6.30 y,61.11±10.26 y,58.1±8.9 y,and 56.9±4.6 y,respectively)contained of 46,36,32,and 46 eyes,respectively.Measurements of vessel density(VD)in the peripapillary region and macula,average retinal inner thickness,and retinal nerve fiber layer thickness(RNFLT)were compared among groups.In order to test the accuracy of differentiation between eyes with and without glaucoma,the area was calculated under the receiver operating characteristic(ROC)curves.RESULTS:The VD in glaucomatous eyes was significantly lower than the control group in all peripapillary sectors(44.35%±6.78%vs 50.47%±1.83%,P<0.001),the superficial(44.08%±5.46%vs 51.28%±2.85%,P<0.001)and the deep(45.13%±8.55%vs 54.20%±5.44%,P<0.001)vascular plexus.There was a significant difference in peripapillary VD between glaucomatous and OHT eyes(44.35%±6.78%vs 49.86%±2.45%,P<0.001).The OHT group featured a lower superficial(48.06%±4.32%vs 51.28%±2.85%,P=0.027)and deep plexus(48.70%±5.99%vs 54.20%±5.44%,P=0.013)whole image vessel density(wiVD)than did the control group.The average macular superficial plexus wiVD was significantly lower in eyes with PXG than in eyes with POAG(42.22%±5.36%vs 46.54%±5.56%,P=0.046).CONCLUSION:OCTA can measure reduced peripapillary and macular VD in eyes with glaucoma and OHT,and these results are correlated to functional and structural glaucomatous alterations.Peripapillary and macular superficial plexus VD is lower in eyes with PXG than in eyes with POAG.Furthermore,the OHT eyes demonstrate impaired macular vasculature in both superficial and deep plexus.
基金Supported by the Natural Science Foundation of Guangdong Province(No.2015A030313019)the Sun Yat-sen Clinical Research Cultivation Project(No.SYS-C-201705)。
文摘AIM:To quantitatively evaluate the effect of the combined use of 577-nm subthreshold micropulse macular laser(SML)and multi-point mode pan retinal laser photocoagulation(PRP)on severe non-proliferative diabetic retinopathy(NPDR)with central-involved diabetic macular edema(CIDME)using optical coherence tomography angiography(OCTA).METHODS:In this observational clinical study,86 eyes of 86 NPDR patients with CIDME who underwent SML and PRP treatment were included.Images were obtained 1 d before laser and post-laser(1 d,1 wk,1,3,and 6 mo)using AngioV ue software 2.0.Best corrected visual acuity(BCVA,LogM AR),foveal avascular zone area(FAZ),choriocapillary flow area(Ch F),parafoveal vessel density(PVD),capillary density inside disc(CDD),peripapillary capillary density(PCD),macular ganglion cell complex thickness(m GCCT),central macular thickness(CMT),and subfoveal choroidal thickness(ChT)were compared between pre-and post-laser treatment.RESULTS:BCVA remained stable during 6 mo postlaser therapy(pre-laser vs 6 mo post-laser:0.53±0.21 vs 0.5±0.15,P>0.05).PVD,ChF,ChT,CMT,and mGCCT significantly increased 1 d post-laser therapy[pre-laser vs 1 d post-laser:superficial PVD(%),40.51±3.42 vs 42.43±4.68;deep PVD(%),42.66±3.67 vs 44.78±4.52;ChF,1.72±0.21 vs 1.9±0.12 mm^2;ChT,302.45±69.74 vs 319.38±70.93μm;CMT,301.65±110.78 vs 320.86±105.62μm;m GCCT,105.71±10.72 vs 115.46±9.64μm;P<0.05].However,PVD,ChF and ChT decreased to less than baseline level at 6 mo postlaser therapy(pre-laser vs 6 mo post-laser:superficial PVD(%),40.51±3.42 vs 36.32±4.19;deep PVD(%),42.66±3.67 vs 38.76±3.74;Ch F,1.72±0.21 vs 1.62±0.09 mm^2;Ch T,302.45±69.74 vs 289.61±67.55μm;P<0.05),whereas CMT and mG CCT decreased to baseline level at 6 mo postlaser therapy(CMT,301.65±110.78 vs 297.77±90.23μm;m GCCT,105.71±10.72 vs 107.05±11.81μm;P>0.05).Moreover,FAZ continuously increased while CDD and PCD continuously decreased in 6 mo after laser therapy.CMT and ChT had a significant positive correlation with ChF and PVD in most post-laser stages.CONCLUSION:During a 6-month follow-up period after combined use of SML and PRP therapy,BCVA remained stable and there was a decreased trend in macular edema.Blood flow increased at 1 d post-laser therapy and reduced at 6 mo post-laser therapy.
文摘AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and to explore changes in retinal function.METHODS:Twenty-nine patients with ATD and 26 age-matched normal subjects were enrolled.All subjects underwent OCTA scans to analyse the superficial retinal vessel parameters in the macular area,including the vessel length density,the vessel perfusion density and the area of foveal avascular zone(FAZ),as well as the choroidal thickness.The differences between the patients with ATD and the normal control group were compared and explored the relevant factors affecting vessel parameters.We also recorded the flash ERGs using the RETeval system and intended to explore changes in retinal function by analysing the ERG image amplitude in patients with ATD.RESULTS:The vessel parameters[Pvessel length density=0.005 and Pvessel perfusion density=0.006]and average choroid thickness(P<0.001)in the macular area of the ATD group was less than the control group.The FAZ area was statistically significantly enlarged in the ATD group(P<0.001).These parameters were correlated with the Mini-Mental State Examination(MMSE)score and the Montreal Cognitive Assessment(MoCA).CONCLUSION:Patients with ATD exhibit decreases in the parameters associated with fundus.In addition,these indicators significantly correlate with the MMSE score and the MoCA score.OCTA may be an adjunct tool with strong potential to track changes in the diagnosis and monitoring the progression of the disease.
基金Supported by National Key Research and Development Program for Precision Medicine of China (No.2016YFC0904800)
文摘AIM: To compare the clinical performance of 4 spectraldomain(SD) optical coherence tomography angiography(OCTA) systems: AngioVueTM, AngioPlexTM, Spectralis? OCTA, AngioScan, and 1 swept-source(SS) OCTA SS OCT AngioTM. METHODS: Twenty-seven undilated right eyes of 27 participants underwent OCTA examination using five different systems respectively for both 3×3 and 6×6 mm2 scan pattern(Spectralis OCTA for 3×3 mm2 scan only). Image quality, including vessel valid visibility and the number of motion artifacts, and acquisition time were evaluated. Repeated measures analysis of variance(ANOVA) with Bonferroni's post-test and Friedman test with Dunn's posttest were used to compare measurements.RESULTS: The age of the subjects was 28.19±5.55 y(range, 23-49 y). The spherical equivalent refraction was-2.55±1.84 D(range, 0.00 to-5.25 D). Significant difference was observed in the evaluation of vessel valid visibility(Angio Vue the highest: 0.111±0.031 for 3×3 mm2 scan and 0.128±0.020 for 6×6 mm2 scan), number of motion artifacts(AngioVue the fewest: 0.778±1.086 for 3×3 mm2 scan and 0.333±0.620 for 6×6 mm2 scan) and acquisition time(AngioPlex the shortest: 8.537±1.921 s for 3×3 mm2 scan and 8.298±1.741 s for 6×6 mm2 scan; all P<0.001). CONCLUSION: There is poor agreement of measurements among systems. AngioVue provides images with the highest vessel valid visibility and the fewest motion artifacts. AngioPlex achieves the shortest acquisition.
基金National Natural Science Foundation of China(No.81741058)Key Research and Development Program of Shaanxi Province(No.2021SF-155)First Affiliated Hospital of Xi’an Jiaotong University(No.2019QN-05).
文摘AIM:To quantitatively detect aqueous levels of angiopoietin-like(ANGPTL)3,ANGPTL4,and ANGPTL6 and investigate their correlation with optical coherence tomography angiography(OCTA)findings in patients with diabetic macular edema(DME).METHODS:This cross-sectional study included 23 patients(27 eyes)with type 2 diabetes and 16 control subjects(20 eyes).All patients underwent OCTA imaging and ultra-wide field fundus photography.Diabetic patients were categorized into two groups according to the presence or absence of diabetic retinopathy(DME group,14 patients,16 eyes);and non-diabetic retinopathy(NDR)group,9 patients,11 eyes,respectively.Aqueous levels of ANGPTL3,ANGPTL4,and ANGPTL6 were assessed using suspension array technology,and foveal-centered 3×3 mm2 OCTA scans were automatically graded to determine the central,inner,and full vessel density(CVD,IVD,FVD);central,inner,and full perfusion density(CPD,IPD,FPD),foveal avascular zone(FAZ)area,FAZ perimeter,and FAZ circularity index(FAZ-CI)on superficial capillary plexuses.Additionally,central subfield thickness(CST),cube volume(CV),and cube average thickness(CAT)were measured in a model of macular cube 512×128.RESULTS:Aqueous ANGPTL3 levels were not significantly different among the three groups(P>0.05).ANGPTL4 levels were significantly higher in the DME group than the control and NDR groups(P<0.0001 and P<0.001),while ANGPTL6 levels were significantly higher in the DME group than the control group(P<0.05).In the whole cohort,the aqueous ANGPTL3 levels correlated negatively with the IVD,FVD,IPD,and FPD,and positively with the CV and CAT.The aqueous ANGPTL4 levels correlated negatively with the CVD,IVD,FVD,CPD,IPD,and FPD,and positively with the FAZ perimeter,CST,CV,and CAT.The aqueous ANGPTL6 levels correlated negatively with the IVD,FVD,IPD,FPD,FAZCI and positively with CST,CV,CAT.CONCLUSION:ANGPTL4 and ANGPTL6 may be associated with vascular leakage in DME and may represent good targets for DME therapy.In addition,OCTA metrics may be useful for evaluating macular ischemia in DME.
基金National Natural Science Foundation of China(No.82174445)China Post-doctoral Science Foundation in 2019(No.2019M650987)Natural Science Foundation of Beijing of China(No.7192235).
文摘Retinitis pigmentosa(RP)is the most recognized inherited retinal disorder involving progressive photoreceptors degeneration which eventually causes blindness.However,the pathogenesis of RP is still unclear,making it difficult to establish satisfying treatments.Evidence have been found to support the theory that vascular dysfunction is associated with the progression of RP.Optical coherence tomography angiography(OCTA)is a newly developed technology that enables visualization as well as quantitative assessment of retinal and choroidal vasculature noninvasively.Advances in OCTA have opened a window for indepth understanding of RP pathogenesis.Here,we propose a hypothesis of RP pathogenesis based on the current OCTA findings in RP,which includes four stages and two important key factors,vascular dysfunction and microglia activation.Further,we discuss the future animal experiments needed and how advanced OCTA technology can help to further verity the hypothesis.The final goal is to explore potential treatment options with enhanced understanding of RP pathogenesis.
