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Tasli NG, Gunay BO, Ugurlu A, Eren MA, Aykut M, Esenülkü CM. Optical coherence tomography angiography in non-alcoholic fatty liver disease: is it a disease affecting the microvascular system?? BMC Ophthalmol 2025; 25:311. [PMID: 40410774 PMCID: PMC12102921 DOI: 10.1186/s12886-025-04136-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2025] [Accepted: 05/13/2025] [Indexed: 05/25/2025] Open
Abstract
PURPOSE To investigate retinal thickness and vascular structure in patients with non-alcoholic fatty liver disease (NAFLD) using optical coherence tomography (OCT) and OCT angiography (OCTA) and to compare the results with healthy controls. METHOD The medical records of NAFLD patients were retrospectively reviewed. Macular thickness (MT) and peripapillary retinal nerve fibre layer (pRNFL) thickness were assessed. The vessel density (VD) of Superficial Capillary Plexus (SCP), Deep Capillary Plexus (DCP), foveal avascular zone (FAZ) area, FAZ circularity index (CI), and FAZ perimeter were also recorded. RESULTS The study included 64 patients with NAFLD and 64 healthy controls. Mean MT and pRNFLT were similar between groups. The study group showed a significant reduction in VD-DCP compared to the control group (36.0 ± 5.2 vs. 38.5 ± 4.1, p < 0.001). Total FAZ area was greater in the study group than in the control group (0.42 ± 0.10 vs. 0.33 ± 0.12mm2, p < 0.001). FAZ CI also differed between groups (0.47 ± 0.08 vs. 0.53 ± 0.08, p < 0.001). Enlarged FAZ area and decreased VD-DCP were significantly associated with NAFLD severity. CONCLUSION Individuals with NAFLD have certain changes in the retinal microvasculature, including reduced VD-DCP, an increased FAZ area, and a decreased of FAZ CI. The variations in VD-DCP and FAZ area exhibit discrepancies according to the disease grade. There are some limitations, including its retrospective nature, the small number of participants, the lack of analysis of the peripapillary area, and the lack of examination of longitudinal changes.
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Affiliation(s)
- Nurdan Gamze Tasli
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Resarch Hospital, Trabzon, Turkey.
| | - Betul Onal Gunay
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Resarch Hospital, Trabzon, Turkey
| | - Adem Ugurlu
- Department of Ophthalmology, College of Medicine, Erzincan Binali Yıldırım University Hospital, Erzincan, Turkey
| | - Mehtap Arslanturk Eren
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Resarch Hospital, Trabzon, Turkey
| | - Murat Aykut
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Resarch Hospital, Trabzon, Turkey
| | - Cenap Mahmut Esenülkü
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Resarch Hospital, Trabzon, Turkey
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Janik A, Jurczyszyn K, Wojtowicz A, Zieliński F, Trafalski M. Application of Fractal Dimension Analysis of Sublingual Blood Vessel Patterns in Correlation with Cardiovascular Diseases-A Pilot Study Title. J Clin Med 2025; 14:1429. [PMID: 40094907 PMCID: PMC11901057 DOI: 10.3390/jcm14051429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 02/07/2025] [Accepted: 02/18/2025] [Indexed: 03/19/2025] Open
Abstract
Background/Objectives: The blood vessel network can be used as a potential marker of general health. In the oral cavity, it is possible to diagnose systemic diseases as the manifestations of many metabolic, cardiovascular, hematological, and autoimmune diseases may represent in lingual tissue. Methods: In the present study, a fractal dimension analysis (FD) of blood vessels of the tongue was applied as a marker of the physiology as well as pathology of cardiovascular diseases. This study was conducted for old men and women aged 68-95 years. Intraoral photography of the lower surface of the tongue was analyzed and correlated with cardiovascular diseases. Results: Differences in the value of the fractal dimension of blood vessels, between hypertension and the control group, were found, as well as in heart coronary disease, atherosclerosis, and heart valve defects. Conclusions: FD changes in the microvascular network of the ventral surface of the tongue can be regarded as potential markers of certain systemic diseases. Based on them, diseases with a cardiovascular basis can be identified, which may expedite the diagnostic process for patients or serve the long-term monitoring of these conditions.
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Affiliation(s)
- Anastazja Janik
- Department of Dental Surgery, Medical University of Warsaw, St. Binieckiego 6, 02-097 Warszawa, Poland; (A.J.)
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Andrzej Wojtowicz
- Department of Dental Surgery, Medical University of Warsaw, St. Binieckiego 6, 02-097 Warszawa, Poland; (A.J.)
| | - Fryderyk Zieliński
- Department of Dental Surgery, Medical University of Warsaw, St. Binieckiego 6, 02-097 Warszawa, Poland; (A.J.)
| | - Mateusz Trafalski
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
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Jeremic N, Pawloff M, Lachinov D, Rokitansky S, Hasun M, Weidinger F, Pollreisz A, Bogunović H, Schmidt-Erfurth U. Severity Stratification of Coronary Artery Disease Using Novel Inner Ellipse-Based Foveal Avascular Zone Biomarkers. Invest Ophthalmol Vis Sci 2024; 65:15. [PMID: 39382880 PMCID: PMC11469242 DOI: 10.1167/iovs.65.12.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 09/16/2024] [Indexed: 10/10/2024] Open
Abstract
Purpose Given the similarities between the retinal and coronary microvasculature, the retina holds promising potential to serve as a non-invasive screening tool for coronary artery disease (CAD). We aimed to develop novel inner ellipse-based metrics and discern whether foveal avascular zone (FAZ) alterations can serve as indicators for CAD presence and severity. Methods Patients admitted to the Department of Cardiology who underwent coronary angiography were included. This resulted in an inclusion of 212 patients, of which 73 had no CAD. During the same visit, 6 × 6-mm (nominal size) fovea-centered optical coherence tomography angiography images of both eyes were acquired. The Gensini score (GS) was utilized to quantify CAD severity. Six known FAZ shape metrics were assessed and three novel biomarkers based on the inner ellipse were defined: absolute inner ellipse difference, Hausdorff distance, and Chamfer distance. Results Eight out of nine metrics showed significant associations with the GS in the left eye. However, significant differences across three CAD severity groups were only demonstrated by the novel metrics. Utilizing the Chamfer distance, age, and sex, patients with and without CAD could be distinguished with an average area under the curve (AUC) of 0.89 (95% confidence interval [CI], 0.84-0.95). Moreover, three CAD severity groups could be discerned with a macro average AUC of 0.77 (95% CI, 0.72-0.84). Conclusions A comprehensive assessment of FAZ shape descriptors was performed, and a strong association with CAD was found. The inner ellipse-based biomarkers especially demonstrated high predictive abilities for CAD presence and severity.
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Affiliation(s)
- Natasa Jeremic
- Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Maximilian Pawloff
- Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Dmitrii Lachinov
- Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Artificial Intelligence in Retina, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Stephanie Rokitansky
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Matthias Hasun
- Department of Internal Medicine II, Division of Cardiology, Clinic Landstraße, Vienna, Austria
| | - Franz Weidinger
- Department of Internal Medicine II, Division of Cardiology, Clinic Landstraße, Vienna, Austria
| | - Andreas Pollreisz
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Hrvoje Bogunović
- Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Artificial Intelligence in Retina, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Ursula Schmidt-Erfurth
- Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
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Di Nardo G, Di Pippo M, Zenzeri L, Mennini M, Piccirillo M, Furio S, Quatrale G, Evangelisti M, Parisi P, Lucchini L, Ferretti A, Villa MP, Scuderi G, Amadè DS, Abdolrahimzadeh S. Ocular endothelial dysfunction in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:1297-1304. [PMID: 38587115 DOI: 10.1002/jpn3.12208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/28/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES To assess ocular microvasculature changes using optical coherence tomography angiography (OCTA) in pediatric patients with inflammatory bowel disease (IBD). METHODS Patients (aged 6-18 years) with IBD were recruited between September 2021 and May 2023. All eligible participants underwent comprehensive clinical assessment and laboratory investigation. Patients with functional gastrointestinal disorders served as the controls. This study assessed specific IBD phenotypes, disease duration, clinical and endoscopic activity indices, laboratory markers, and medication histories. OCTA was utilized to evaluate ocular microvasculature changes in both groups. RESULTS A total of 63 children (mean age 12.9 ± 3.3 years) were enrolled, comprising 38 in the IBD group (16 ulcerative colitis, 22 Crohn's disease, and 25 in the control group). Most patients in the IBD group were in remission or had mild-to-moderate disease activity at enrollment. Analysis of the OCTA results revealed significant differences in the choroidal luminal area and total choroidal area between the IBD and control groups. CONCLUSIONS The study identified distinct ocular microvasculature changes in pediatric IBD patients through OCTA, suggestive of potential systemic endothelial dysfunction. These findings underscore the utility of OCTA in evaluating microvascular alterations associated with pediatric IBD, offering insights into potential systemic complications linked to inflammation in IBD patients.
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Affiliation(s)
- Giovanni Di Nardo
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Mariachiara Di Pippo
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Ophthalmology Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Letizia Zenzeri
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
- Emergency Pediatric Department, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maurizio Mennini
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Marisa Piccirillo
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Silvia Furio
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Giovanna Quatrale
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Melania Evangelisti
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Pasquale Parisi
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Livia Lucchini
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Alessandro Ferretti
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Maria Pia Villa
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Pediatric Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Gianluca Scuderi
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Ophthalmology Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - David Sarzi Amadè
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Stomatology Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Solmaz Abdolrahimzadeh
- Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Ophthalmology Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
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Manfredini M, Ragusa E, Gibertini M, Bigi L, Ferrari B, Lasagni C, Magnoni C, Lazzerini A, Farnetani F, Verdina T. Retinal Microvascular Alterations in Hidradenitis Suppurativa Patients: A Pilot Study Using Optical Coherence Tomography Angiography. J Clin Med 2024; 13:1464. [PMID: 38592296 PMCID: PMC10932047 DOI: 10.3390/jcm13051464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/07/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Hidradenitis suppurativa (HS) is a relapsing-remitting inflammatory disease characterized by the progression of asymptomatic nodules to deep-seated lesions and fistula formation that leads to suppuration and scarring. Optical coherence tomography angiography (OCTA) is a new non-invasive imaging technique that carefully analyzes retinal microvasculature networks with high-resolution imaging. Recent studies have demonstrated that retinal vessel density and retinal perfusion reflect systemic inflammatory responses. This study's aim was to analyze OCTA-derived retinal microvasculature parameters to understand if patients affected by HS and without any relevant ocular or systemic comorbidities showed impaired retinal vascular function and morphology. Method: We performed a case-control study of HS patients and age- and sex-matched control cohort. A total of 20 eyes from 10 HS patients and 30 eyes from 15 healthy controls were analyzed, and OCTA-derived microvasculature parameters were compared between groups. Results: OCTA images showed that HS patients, compared to healthy controls, were typically characterized by higher values of the foveal avascular zone (FAZ) both in the superficial capillary plexus (SCP) and in the deep capillary plexus (DCP), and by lower values of vessel density (VD)-SCP, VD-DCP, and vessel length density (VLD)-SCP in the foveal region. These findings partially reflect changes that have been demonstrated in diabetic patients that could be induced by a protracted metabolic or systemic inflammatory dysregulation. Conclusions: In conclusion, OCTA enables large-scale, non-invasive visual screening and follow-up of the retinal vasculature features, providing a new strategy for the prevention and monitoring of visual changes in HS patients.
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Affiliation(s)
- Marco Manfredini
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Emanuele Ragusa
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Matteo Gibertini
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Laura Bigi
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Barbara Ferrari
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Claudia Lasagni
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Cristina Magnoni
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Andrea Lazzerini
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy (C.L.)
| | - Tommaso Verdina
- Institute of Ophthalmology, Department of Surgical, Medical, Dental & Morphological Sciences with Interest Transplant, Oncological & Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Kurumoğlu Incekalan T, Celik U, Tolunay O, Naz Şimdivar GH, Alyamaç Sukgen E. Changes in retinal and choroidal capillary dynamics in patients with multisystem inflammatory syndrome in children. Int Ophthalmol 2023; 43:3-12. [PMID: 36036326 PMCID: PMC9421118 DOI: 10.1007/s10792-022-02382-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/14/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate patients with multisystemic inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using optical coherence tomography angiography (OCTA) during and after resolution of inflammation to investigate the effect of this entity on the retinal and choroidal circulation. METHODS The study included 38 eyes of 19 patients diagnosed as having MIS-C between March 2021 and June 2021. OCTA measurements of choroidal thickness and vessel density in the radial peripapillary capillary plexus (RPCP), superficial capillary plexus (SCP), and deep capillary plexus (DCP) obtained at time of diagnosis and 60 days later were compared. Correlations between C-reactive protein (CRP) levels at diagnosis and retinochoroidal involvement were investigated. RESULTS Compared to post-recovery follow-up examinations, patients with active MIS-C showed foveal avascular zone enlargement (p = 0.031), decreased vessel density in the temporal parafoveal SCP (p = 0.047) and all parafoveal areas of the DCP (p < 0.05 for all), and increased choroidal thickness (p = 0.021). Correlation analysis between CRP levels and OCTA changes during MIS-C revealed significant negative correlations with all parafoveal sectors of the SCP and DCP and a significant positive correlation with CT. CONCLUSION There were especially marked effects on the DCP and choroid in MIS-C patients. Our findings also correlate with CRP levels. The use of optical coherence tomography angiography in patients with multisystemic inflammatory syndrome may have potential future implications for detecting ocular microvascular changes that occur before permanent damage develops. Clinical Trial Registration Number and Date: 77/1340; March 1, 2021.
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Affiliation(s)
- Tuğba Kurumoğlu Incekalan
- Depertmant of Opthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Umit Celik
- Pediatric Infectious Diseases, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Orkun Tolunay
- Pediatric Infectious Diseases, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Goksu Hande Naz Şimdivar
- Depertmant of Opthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Emine Alyamaç Sukgen
- Depertmant of Opthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
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McGrath OE, Aslam TM. Use of Imaging Technology to Assess the Effect of COVID-19 on Retinal Tissues: A Systematic Review. Ophthalmol Ther 2022; 11:1017-1030. [PMID: 35488102 PMCID: PMC9053559 DOI: 10.1007/s40123-022-00509-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/01/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate the effect of COVID-19 on retinal tissues by conducting a systematic review and meta-analysis of the current literature. BACKGROUND The novel coronavirus disease is not yet well understood. The orbit provides a window into the body's microvasculature, and as such, it is a non-invasive opportunity to analyse the systemic circulation in vivo. By analysing the current literature, we test the hypothesis that non-invasive imaging of the retina could provide insight into the effect of COVID-19 on the retinal microvasculature. METHODS For this systematic review and meta-analysis, we screened PubMed databases and LitCOVID19 using the search criteria: (OCTA or Optical Coherence Tomography Angiography) AND (COVID-19 or corona or SARS-CoV-2) AND (retina or fundus). Databases were searched on 11 January 2022. The primary study outcomes were studies that utilised OCTA to analyse the retina; secondary outcomes involved studies that involved other imaging modalities such as OCT, fundus photography, and fundus autofluorescence. FINDINGS The total number of studies included in this review was 32. Optical coherence tomography angiography scans show reduced central retinal vascular density, a thinner ganglion cell layer, a thicker retinal nerve fibre layer, and an enlarged foveal avascular zone. Optical coherence tomography scans demonstrate a thicker central macular thickness and other changes to the macula, ganglion cell, and inner nuclear layers. Many fundus photographs depicted cotton wool spots, microhaemorrhages, and vascular occlusions. Non-invasive imaging technology has demonstrated that COVID-19 can profoundly affect the retina. Therefore, there is a requirement for long-term follow-up of COVID-19 patients to assess whether the retinal damage caused by COVID-19 is reversible.
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Affiliation(s)
- Orlaith E. McGrath
- Manchester Royal Eye Hospital, Manchester, UK
- The University of Manchester, Manchester, UK
| | - Tariq M. Aslam
- Manchester Royal Eye Hospital, Manchester, UK
- The University of Manchester, Manchester, UK
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8
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Kurumoğlu İncekalan T, Kışla Ekinci RM, Naz Şimdivar GH, Doğan NÇ, Çiloğlu E. Evaluation of subclinical ocular involvement in patients with deficiency of adenosine deaminase 2 (DADA2). Clin Rheumatol 2022; 41:2533-2540. [PMID: 35508675 DOI: 10.1007/s10067-022-06194-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate changes in the peripapillary, macular, and choroidal microvasculature in the eyes of patients with deficiency of adenosine deaminase 2 (DADA2) and no clinical signs of ocular involvement. METHODS The study included 12 eyes of 12 patients with DADA2 and 24 eyes of 24 healthy subjects. The foveal avascular zone (FAZ), macular vessel densities (VDs) in the superficial and deep retinal capillary plexuses, peripapillary VDs, and choroidal thickness were evaluated by optical coherence tomography angiography (OCTA). Measurements were compared between DADA2 patients and healthy controls. RESULTS The median age was 17 (8-25) years in DADA2 patients and 17.5 (7-23) years in control group at the OCTA visit (p = 0.934). FAZ area did not differ between the groups (p = 0.224). In the superficial capillary plexus, whole-image, foveal, and parafoveal VD values were slightly lower in DADA2 patients than in controls (p = 0.054, p = 0.052, p = 0.117). In the deep capillary plexus, whole-image and parafoveal VD values were significantly lower in DADA2 patients than controls (p = 0.010, p = 0.001). VD in the radial peripapillary capillary plexus was also lower in DADA2 patients, with significantly lower peripapillary VD (p = 0.002). Subfoveal choroidal thickness was significantly higher in patients with DADA2 (p < 0.001). CONCLUSIONS This OCTA study demonstrates that both retinal and choroidal involvement may occur in DADA2 patients before the emergence of evident clinical findings.
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Affiliation(s)
- Tuğba Kurumoğlu İncekalan
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey.
| | - Rabia Miray Kışla Ekinci
- Department of Pediatric Rheumatology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Göksu Hande Naz Şimdivar
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Neşe Çetin Doğan
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Emine Çiloğlu
- Department of Ophthalmology, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
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9
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Isik I, Yaprak L, Yaprak A, Akbulut U. Optical coherence tomography angiography findings of retinal vascular structures in children with celiac disease. J AAPOS 2022; 26:69.e1-69.e4. [PMID: 35085756 DOI: 10.1016/j.jaapos.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/25/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the vasculature of the retina and choroid in children with celiac disease using optical coherence tomography angiography (OCTA). METHODS A total of 60 children with celiac disease and 71 healthy controls were included in this study. All participants underwent comprehensive ophthalmologic examination and OCTA imaging. The vascular structures and the vascular density (VD) in the superficial and deep retinal vascular zones, the foveal avascular zone (FAZ) and foveal density were automatically determined using the software 3 × 3 OCTA and AngioAnalytics. Choroid thickness was calculated manually by retinal specialists. RESULTS No statistically significant difference in VD was found between subjects and controls. The FAZ was larger in the celiac group than in controls (0.306 ± 0.12 mm2 vs 0.287 ± 0.11 mm2), but the difference was not statistically significant (P = 0.383). Subfoveal choroid thickness was thinner in the celiac group (309.9 ± 76.97 μm) than in the control group (328 ± 68.51 μm), but the difference was not statistically significant (P = 0.157) CONCLUSIONS: No statistically significant differences in VD, mean FAZ or mean subfoveal choroidal thickness were found in children with CD compared to controls.
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Affiliation(s)
- Ishak Isik
- Department of Pediatric Gastroenterology Hepathology and Nutrition, University of Health Sciences Antalya Training and Research Hospital.
| | - Lutfiye Yaprak
- Department of Ophthalmology, University of Health Sciences Antalya Training and Research Hospital
| | - Asli Yaprak
- Department of Ophthalmology, University of Health Sciences Antalya Training and Research Hospital
| | - Ulas Akbulut
- Department of Pediatric Gastroenterology Hepathology and Nutrition, University of Health Sciences Antalya Training and Research Hospital
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10
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Zapata MÁ, Banderas García S, Sánchez-Moltalvá A, Falcó A, Otero-Romero S, Arcos G, Velazquez-Villoria D, García-Arumí J. Retinal microvascular abnormalities in patients after COVID-19 depending on disease severity. Br J Ophthalmol 2022; 106:559-563. [PMID: 33328184 PMCID: PMC7745458 DOI: 10.1136/bjophthalmol-2020-317953] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Global pandemic SARS-CoV-2 causes a prothrombotic state without fully elucidated effects. This study aims to analyse and quantify the possible retinal microvascular abnormalities. MATERIALS AND METHODS Case-control study. Patients between 18 and 55 years old with PCR-confirmed SARS-CoV-2 infection within the last 3 months were included. RISK STRATIFICATION group 1-mild disease (asymptomatic/paucisymptomatic); group 2-moderate disease (required hospital admission with no acute respiratory distress) and group 3-severe disease (subjects who developed an acute respiratory distress were admitted in the intensive care unit and presented interleukin 6 values above 40 pg/mL). Age-matched volunteers with negative serology tests were enrolled to control group. A colour photograph, an optical coherence tomography (OCT) and an angiography using OCT centred on the fovea were performed. RESULTS Control group included 27 subjects: group 1 included 24 patients, group 2 consisted of 24 patients and 21 participants were recruited for group 3. There were no funduscopic lesions, neither in the colour images nor in the structural OCT. Fovea-centred vascular density (VD) was reduced in group 2 and group 3 compared with group 1 and control group (control group vs group 2; 16.92 vs 13.37; p=0.009) (control group vs group 3; 16.92 vs .13.63; p=0.026) (group 1 vs group 2; 17.16 vs 13.37; p=0.006) (group 1 vs group 3; 17.16 vs 13.63 p=0.017). CONCLUSION Patients with moderate and severe SARS-CoV-2 pneumonia had decreased central retinal VD as compared with that of asymptomatic/paucisymptomatic cases or control subjects.
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Affiliation(s)
- Miguel Ángel Zapata
- Ophthalmology Service, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Sandra Banderas García
- Ophthalmology Service, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
- Department of Surgery, Autonomous University of Barcelona, Barcelona, Catalunya, Spain
| | - Adrián Sánchez-Moltalvá
- Infectious Diseases Department, Autonomous University of Barcelona, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Anna Falcó
- Infectious Diseases Department, Autonomous University of Barcelona, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Susana Otero-Romero
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | | | | | - Jose García-Arumí
- Ophthalmology Service, Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
- Ocular Microsurgery Institute (IMO), Barcelona, Spain
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Debourdeau E, Charmard C, Carriere I, Plat J, Villain M, Boivineau L, Altwegg R, Daien V. Retinal Microcirculation Changes in Crohn’s Disease Patients under Biologics, a Potential Biomarker of Severity: A Pilot Study. J Pers Med 2022; 12:jpm12020230. [PMID: 35207718 PMCID: PMC8878992 DOI: 10.3390/jpm12020230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
Crohn’s disease (CD) is associated with increased cardiovascular risk and the retinal microcirculation is a reflection of the systemic microcirculation. Is the retinal microcirculation altered in relation to the severity of Crohn’s disease? This cross-sectional case-controlled study was conducted in a university hospital center from November 2020 to February 2021. We prospectively included patients with moderate (biologic therapy) or severe (biologic therapy + peri-anal disease and/or digestive resection) CD and age- and sex-matched controls. Individuals with diabetes, renal disease, cardiovascular disease, ophthalmological history or poor quality images were excluded. All participants underwent OCT angiography (OCT-A) imaging (Optovue, Fremont, CA). Analysis of covariance was used. 74 CD patients (33 moderate, 41 severe) and 74 controls (66 (44.6%) men; mean (SD) age 44 (14) years) were included. Compared with the controls, the severe CD patients showed a significantly reduced mean foveal avascular zone area (p = 0.001), superficial macular capillary plexus vessel density (p = 0.009) and parafoveal thickness (p < 0.001), with no difference in mean superficial capillary flow index (p = 0.06) or deep macular capillary plexus vessel density (p = 0.67). The mean foveal avascular zone was significantly lower in the severe than the moderate CD patients (p = 0.010). OCT-A can detect alterations in retinal microcirculation in patients with severe versus moderate CD and versus age- and sex-matched controls.
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Affiliation(s)
- Eloi Debourdeau
- Department of Ophthalmology, Gui de Chauliac Hospital, F-34000 Montpellier, France; (C.C.); (J.P.); (M.V.)
- Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, F-34091 Montpellier, France;
- Correspondence: (E.D.); (V.D.); Tel.: +33-648-263-565 (E.D.); +33-673-055-877 (V.D.)
| | - Chloé Charmard
- Department of Ophthalmology, Gui de Chauliac Hospital, F-34000 Montpellier, France; (C.C.); (J.P.); (M.V.)
- Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, F-34091 Montpellier, France;
| | - Isabelle Carriere
- Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, F-34091 Montpellier, France;
| | - Julien Plat
- Department of Ophthalmology, Gui de Chauliac Hospital, F-34000 Montpellier, France; (C.C.); (J.P.); (M.V.)
| | - Max Villain
- Department of Ophthalmology, Gui de Chauliac Hospital, F-34000 Montpellier, France; (C.C.); (J.P.); (M.V.)
| | - Lucile Boivineau
- Department of Gastroenterology and Hepatology, Saint-Eloi Hospital, F-34000 Montpellier, France; (L.B.); (R.A.)
| | - Romain Altwegg
- Department of Gastroenterology and Hepatology, Saint-Eloi Hospital, F-34000 Montpellier, France; (L.B.); (R.A.)
| | - Vincent Daien
- Department of Ophthalmology, Gui de Chauliac Hospital, F-34000 Montpellier, France; (C.C.); (J.P.); (M.V.)
- Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, F-34091 Montpellier, France;
- The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW 2000, Australia
- Correspondence: (E.D.); (V.D.); Tel.: +33-648-263-565 (E.D.); +33-673-055-877 (V.D.)
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12
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Optical coherence tomography angiography (OCTA) in differential diagnosis of aquaporin-4 antibody seronegative NMOSD and multiple sclerosis. Mult Scler Relat Disord 2022; 58:103503. [PMID: 35030370 DOI: 10.1016/j.msard.2022.103503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/06/2021] [Accepted: 01/03/2022] [Indexed: 11/22/2022]
Abstract
BACKROUND Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment. OBJECTIVE To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences. METHODS Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer(RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed. RESULTS OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p<0.001 and p = 0.010, p<0.001 respectively). Peripapillary VD was similar in RRMS +ON and controls. Peripapillary VD in monophasic seronegative NMOSD+ON eyes was significantly lower than monophasic RRMS+ON eyes (p = 0.030), which was no different from controls. FAZ area was smaller in unaffected eyes in NMOSD than RRMS and controls. CONCLUSIONS Both OCT and OCTA revealed considerable differences between RRMS and NMOSD patients, providing promising results in favor of clinical utility of OCTA in differential diagnosis of ON, particularly in anti-AQP4 antibody negative patients. OCTA might be a useful biomarker in differentiating NMOSD from MS.
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Lee J, Cho H, Kang M, Hong R, Seong M, Shin Y. Retinal Changes before and after Silicone Oil Removal in Eyes with Rhegmatogenous Retinal Detachment Using Swept-Source Optical Coherence Tomography. J Clin Med 2021; 10:jcm10225436. [PMID: 34830717 PMCID: PMC8619201 DOI: 10.3390/jcm10225436] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/04/2021] [Accepted: 11/18/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to evaluate and compare the retinal and choroidal thickness and vessel density (VD) changes between silicone oil (SO) tamponade and after SO removal using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Thirty patients who underwent pars plana vitrectomy for retinal detachment (RD) with SO tamponade were included. SS-OCT and OCTA were conducted before RD surgery, during SO tamponade, and after SO removal. A 3-dimensional volumetric wide scan protocol was used for the analysis. The segmented retina, choroidal thickness map, and peripapillary thickness were then measured. For the OCTA analysis, 4.5 × 4.5 mm scans were used. Superficial and deep capillary plexus VDs in unaffected fellow eyes and eyes after SO removal were compared. During the SO tamponade period, the thickness of the parafoveal total retina, ganglion cell-inner plexiform layer, and peripapillary retinal nerve fiber layer (ppRNFL) were significantly thinner than those of unaffected fellow eyes (p < 0.05). The parafoveal layer thickness thinning recovered up to three to six months after SO removal. Moreover, six months after SO removal, the parafoveal thickness was not significantly different compared to that of unaffected fellow eyes (p > 0.05). However, the ppRNFL thickness was significantly decreased during SO tamponade and remained unrecovered six months after SO removal. There was no significant difference in the VD on the OCTA. Thus, SO tamponade and removal for RD resulted in a change in the retinal and peripapillary thickness. This may be due to the mechanical pressure effect of SO.
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Stability of OCT and OCTA in the Intensive Therapy Unit Setting. Diagnostics (Basel) 2021; 11:diagnostics11081516. [PMID: 34441449 PMCID: PMC8394026 DOI: 10.3390/diagnostics11081516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
To assess the stability of retinal structure and blood flow measures over time and in different clinical settings using portable optical coherence tomography angiography (OCTA) as a potential biomarker of central perfusion in critical illness, 18 oesophagectomy patients completed retinal structure and blood flow measurements by portable OCT and OCTA in the eye clinic and intensive therapy unit (ITU) across three timepoints: (1) pre-operation in a clinic setting; (2) 24–48 h post-operation during ITU admission; and (3) seven days post-operation, if the patient was still admitted. Blood flow and macular structural measures were stable between the examination settings, with no consistent variation between pre- and post-operation scans, while retinal nerve fibre layer thickness increased in the post-operative scans (+2.31 µm, p = 0.001). Foveal avascular zone (FAZ) measurements were the most stable, with an intraclass correlation coefficient of up to 0.92 for right eye FAZ area. Blood flow and structural measures were lower in left eyes than right eyes. Retinal blood flow assessed in patients before and during an ITU stay using portable OCTA showed no systematic differences between the clinical settings. The stability of retinal blood flow measures suggests the potential for portable OCTA to provide clinically useful measures in ITU patients.
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