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Optical Coherence Tomography Angiography Evaluation of Retinal Microvasculature Before and After Carotid Angioplasty and Stenting.

ABSTRACT: The aim of the study was to evaluate the influence of carotid angioplasty and stenting (CAS) on retinal microvasculature using optical coherence tomography angiography (OCTA) in patients with severe carotid stenosis. 20 patients with severe carotid stenosis underwent comprehensive ophthalmic examinations and OCTA before and one month after CAS. Automated algorithms were used to quantify vessel density in the macular superficial vascular complex (SVC), deep vascular complex (DVC), and radial peripapillary capillary (RPC) around the optic disc. Eyes on the operated side constituted the ipsilateral eye group, and the other eye constituted the fellow eye group. In the ipsilateral eye group, the vessel density in the DVC increased significantly after stent implantation (P?=?0.010), but the vessel density change in the SVC was not statistically different (P?=?0.999). In the fellow eye group, the vessel density in the SVC (P?=?0.028) and DVC (P?=?0.034) were significantly increased after stent implantation. The vessel density in the RPC did not significantly change in the ipsilateral (P?=?0.363) or fellow (P?=?0.878) eye groups. This study shows that unilateral CAS for severe carotid stenosis increases macular vessel densities in both eyes.

SUBMITTER: Lee CW

PROVIDER: S-EPMC6791857 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Optical Coherence Tomography Angiography Evaluation of Retinal Microvasculature Before and After Carotid Angioplasty and Stenting.

Lee Chia-Wei CW Cheng Hui-Chen HC Chang Feng-Chi FC Wang An-Guor AG

Scientific reports 20191014 1

The aim of the study was to evaluate the influence of carotid angioplasty and stenting (CAS) on retinal microvasculature using optical coherence tomography angiography (OCTA) in patients with severe carotid stenosis. 20 patients with severe carotid stenosis underwent comprehensive ophthalmic examinations and OCTA before and one month after CAS. Automated algorithms were used to quantify vessel density in the macular superficial vascular complex (SVC), deep vascular complex (DVC), and radial peri ...[more]

PMID: 31611579

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Project description:PurposeTo investigate factors associated with dropout of the parapapillary deep retinal layer microvasculature assessed by optical coherence tomography angiography (OCTA) in glaucomatous eyes.DesignCross-sectional study.ParticipantsSeventy-one eyes from 71 primary open-angle glaucoma (POAG) patients with β-zone parapapillary atrophy (βPPA) enrolled in the Diagnostic Innovations in Glaucoma Study.MethodsParapapillary deep-layer microvasculature dropout was defined as a complete loss of the microvasculature located within the deep retinal layer of the βPPA from OCTA-derived optic nerve head vessel density maps by standardized qualitative assessment. Circumpapillary vessel density (cpVD) within the retinal nerve fiber layer (RNFL) also was calculated using OCTA. Choroidal thickness and presence of focal lamina cribrosa (LC) defects were determined using swept-source optical coherence tomography.Main outcome measuresPresence of parapapillary deep-layer microvasculature dropout. Parameters including age, systolic and diastolic blood pressure, axial length, intraocular pressure, disc hemorrhage, cpVD, visual field (VF) mean deviation (MD), focal LC defects βPPA area, and choroidal thickness were analyzed.ResultsParapapillary deep-layer microvasculature dropout was detected in 37 POAG eyes (52.1%). Eyes with microvasculature dropout had a higher prevalence of LC defects (70.3% vs. 32.4%), lower cpVD (52.7% vs. 58.8%), worse VF MD (-9.06 dB vs. -3.83 dB), thinner total choroidal thickness (126.5 μm vs. 169.1 μm), longer axial length (24.7 mm vs. 24.0 mm), larger βPPA (1.2 mm2 vs. 0.76 mm2), and lower diastolic blood pressure (74.7 mmHg vs. 81.7 mmHg) than those without dropout (P < 0.05, respectively). In the multivariate logistic regression analysis, higher prevalence of focal LC defects (odds ratio [OR], 6.27; P = 0.012), reduced cpVD (OR, 1.27; P = 0.002), worse VF MD (OR, 1.27; P = 0.001), thinner choroidal thickness (OR, 1.02; P = 0.014), and lower diastolic blood pressure (OR, 1.16; P = 0.003) were associated significantly with the dropout.ConclusionsSystemic and ocular factors including focal LC defects more advanced glaucoma, reduced RNFL vessel density, thinner choroidal thickness, and lower diastolic blood pressure were factors associated with the parapapillary deep-layer microvasculature dropout in glaucomatous eyes. Longitudinal studies are required to elucidate the temporal relationship between parapapillary deep-layer microvasculature dropout and systemic and ocular factors.

Project description:Purpose: To evaluate the conjunctival and fundus retinal vessel density in patients with systemic lupus erythematosus (SLE) with optical coherence tomography angiography (OCTA), and to investigate the relationship between vessel density and clinical indicators. Methods: Twelve patients with SLE (24 eyes) and 12 healthy controls (24 eyes) were recruited. OCTA was used to examine the superficial retina layer (SRL) and deep retina layer (DRL) in the macular retina and conjunctival capillary plexus of each eye. We calculated the density of the temporal conjunctival vessels, fundus microvascular (MIR), macrovascular (MAR) and total MIR(TMI) and compared the results in both groups. We used annular partitioning (C1-C6), hemispheric quadrants, and Early Treatment Diabetic Retinopathy Study partitioning (ETDRS) to analyze changes in the retinal vascular density. Correlation analysis was used to investigate the association between blood capillary density and clinical indicators. Results: OCTA results showed significant differences in the conjunctival microvascular density (p < 0.001). There was no significant difference in MIR, TMI, and MAR in the superficial layers between the SLE and healthy group (p > 0.05). The DRL and DTMI (Deeper TMI) densities were decreased in the macular regions of SLE patients (p < 0.05). In the hemispheric segmentation analysis, the superficial MIR was significantly decreased in the IL (inferior left) region of the SLE patients (p < 0.05), and the deep MIR in the IR (inferior right) region was significantly reduced (p < 0.05). In the ETDRS partitioning analysis, the superficial MIR in the inferior, right, and left subdivisions was significantly decreased in the SLE patients (p < 0.05). In the circular segmentation analysis, the deep MIR in the C1 and C3 regions was significantly reduced in SLE patients (p < 0.05), while the superficial MIR density was decreased only in the C3 region (p < 0.05). The conjunctival vascular density was negatively correlated with the STMI (Superficial TMI) (r = -0.5107; p = 0.0108) and DTMI (r = -0.9418, p < 0.0001). There was no significant correlation between vascular density and SLEDAI-2k (Systemic Lupus Erythematosus Disease Activity Index-2000) (P > 0.05). Conclusion: Clinically, patients with SLE and patients suspected of SLE should receive OCTA examination in a comprehensive eye examination to detect changes in ocular microcirculation at an early stage.

Project description:To describe the features of foveal microvasculature using optical coherence tomography angiography (OCTA) and to determine the related clinical factors in eyes with surgically closed macular hole (MH).A retrospective case series of 18 patients with unilateral MH was reviewed. The patients maintained complete hole closure after vitrectomy with inner limiting membrane (ILM) peeling for at least 12 months. The healthy fellow eyes were studied as controls. The foveal microvasculature of both eyes was examined by OCTA. The area of the foveal avascular zone (FAZ) and the vascular density (VD) ratio in the superficial and deep capillary plexuses (SCP and DCP) were determined after surgery. Several clinical factors including age, stage and dimensions of MH, papillofoveal distance, the extent of nasal displacement of the fovea after surgery, postoperative central foveal thickness, and outer-retina integrity were evaluated to determine any relationships with the OCTA parameters.The mean FAZ area in both the SCP and DCP (0.29?±?0.11 mm2 and 0.39?±?0.14 mm2) was significantly smaller than those of the controls (0.45?±?0.14 mm2 and 0.62?±?0.22 mm2) (p?=?0.001 and <0.001, respectively). The mean VD ratio in the SCP (0.270?±?0.349) was similar to that of the controls (0.321?±?0.189) (p?=?0.231); however, that in the DCP (0.321?±?0.189) was significantly lower than that of the controls (0.331?±?0.119) (p?=?0.025). Only the extent of nasal displacement of the fovea was correlated with the DCP FAZ-area difference values between the study group and the controls (correlation coefficient?=?0.577; p?=?0.012).After successful MH surgery, the FAZ area in both the SCP and DCP was smaller and the VD ratio of the DCP was lower, suggesting a possible DCP vulnerability to tractional stress. As the FAZ area of the DCP in closed-MH eyes became smaller than that in the controls, the fovea was less displaced toward the optic disc, possibly reflecting a lack of retinal redundancy caused by horizontal stretching accompanied by foveal displacement.

Dataset Information

Optical Coherence Tomography Angiography Evaluation of Retinal Microvasculature Before and After Carotid Angioplasty and Stenting.

Publications

Optical Coherence Tomography Angiography Evaluation of Retinal Microvasculature Before and After Carotid Angioplasty and Stenting.

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