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Systemic Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study.

ABSTRACT: PURPOSE:To determine the relationship between systemic factors and radial peripapillary capillary (RPC) vessel density (VD) in healthy African American (AA) participants of the African American Eye Disease Study. DESIGN:A population-based, cross-sectional study. METHODS:A total of 4135 eyes from 2127 AA participants aged 40 years and older in Inglewood, California, were imaged for 6×6-mm optic disc scans on a spectral-domain optical coherence tomography angiography (OCTA) device. Of these, 1029 eyes from 1029 participants who met the inclusion and exclusion criteria were analyzed, including only 1 eye per participant. Custom software was used to quantify RPC VD. Multivariate linear regression was used to identify systemic factors associated with RPC VD with a significance level set at 0.05. The contribution of each variable to the final model was estimated with the magnitude of standardized regression coefficients (SRCs). The fit of the final model was measured by R2. RESULTS:The average RPC VD was 0.346±0.045. Controlling for signal strength, the systemic variables in the final multivariate model associated with reduced RPC VD were older age (? = -0.0123 per decade; SRC = -0.2733; P < .0001), male sex (? = -0.0067; SRC = -0.0716; P = .0060), and longer diabetes duration (? = -0.0022 per 5 years; SRC = -0.0527; P = .0427). The model R2 was 0.3689. CONCLUSIONS:Age, sex, and systemic influences, such as diabetes duration, need to be considered when assessing changes in RPC VD in glaucoma and other ocular diseases. Longitudinal studies are needed to investigate whether reduced RPC VD and the factors that affect it are associated with an increased risk of developing glaucomatous nerve damage.

SUBMITTER: Chang R

PROVIDER: S-EPMC6885532 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Systemic Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study.

Chang Ryuna R Nelson Andrew J AJ LeTran Vivian V Vu Brian B Burkemper Bruce B Chu Zhongdi Z Fard Ali A Kashani Amir H AH Xu Benjamin Y BY Wang Ruikang K RK Varma Rohit R Richter Grace M GM

American journal of ophthalmology 20190621

<h4>Purpose</h4>To determine the relationship between systemic factors and radial peripapillary capillary (RPC) vessel density (VD) in healthy African American (AA) participants of the African American Eye Disease Study.<h4>Design</h4>A population-based, cross-sectional study.<h4>Methods</h4>A total of 4135 eyes from 2127 AA participants aged 40 years and older in Inglewood, California, were imaged for 6×6-mm optic disc scans on a spectral-domain optical coherence tomography angiography (OCTA) d ...[more]

PMID: 31229463

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Project description:Objective: To determine whether systemic vascular dysregulation (SVD) evaluated by nailfold capillaroscope and Flammer Syndrome Questionnaire (FSQ) affects retinal peripapillary microcirculation in non-glaucomatous healthy eyes at steady status. Methods: 120 healthy eyes from 63 non-glaucomatous subjects underwent Optical coherence tomography angiography (OCTA) after a rest of 30 minutes. Average retinal peripapillary capillary (RPC) vessel density (VD) and sectoral VD were automatically calculated, and peripapillary retinal nerve fiber layer thickness (RNFLT) was measured. Vasospastic diathesis was assessed using Flammer Syndrome Questionnaire (FSQ). Cold provocation test (CPT) was performed using nail-fold capillaroscope after OCTA. Positive CPT and a score of FSQ higher than 20% were necessary to determine a subject with SVD. Systemic and ocular parameters were compared between subjects with and without SVD. Results: In this study, heart rate (p = 0.042), ocular perfusion pressure (p = 0.014) and average RPC vessel density (p = 0.046) was significantly different between subjects with and without SVD determined by the combination of CPT and FSQ. Generalized estimation equation (GEE) showed lower VD was significantly associated with longer axial length (β = -0.352, p = 0.001), thinner peripapillary retinal nerve fiber layer thickness (RNFLT) (β = 0.296, p < 0.001), SVD determined by CPT and FSQ (β = 0.617, p = 0.003) and high blood pressure (β = -0.879, p < 0.001). In the superotemporal sector, multivariate model showed only SVD was associated with RPC vessel density (β = -0.811, p < 0.001). Conclusion: In subjects with SVD and non-glaucomatous healthy eyes, lower RPC vessel density in the superotemporal sector was observed. SVD determined by CPT and FSQ was significantly associated with attenuated retinal peripapillary microcirculation. Studies on ocular diseases relevant to vasospasms should consider the effects of SVD on the retinal peripapillary capillaries.

Project description:PurposeWe sought to investigate anatomic mechanisms of angle narrowing by assessing ocular biometric determinants of anterior chamber angle width.DesignPopulation-based cross-sectional study.MethodsSubjects ≥50 years of age from the Chinese American Eye Study underwent a comprehensive ocular examination, including anterior segment optical coherence tomography imaging and ultrasound A-scan. Independent variables, including anterior chamber depth (ACD), lens vault (LV), iris curvature (IC), anterior chamber width, lens thickness, vitreous cavity depth, and axial length, and dependent variables, including angle opening distance, were measured in 1 randomly selected eye per subject. Univariable and multivariable regression models with standardized regression coefficients (SRCs) and semipartial correlation coefficients squares (SPCC2) were used to assess relative and unique contributions by independent variables to angle width.ResultsTwo thousand two hundred twenty-five subjects (1433 women and 834 men) were included in the analysis. All biometric parameters except lens thickness differed between men and women (age-adjusted P < .001). In model 1A (R2 = 0.66), which included ACD, lens thickness, and vitreous cavity depth, ACD (SRC = 0.64, SPCC2 = 0.19) and IC (SRC = -0.26, SPCC2 = 0.041) were the strongest determinants of angle opening distance. In model 1B (R2 = 0.58), which included LV and axial length, LV (SRC = -0.46, SPCC2 = 0.1) and IC (SRC = -0.3, SPCC2 = 0.047) were the strongest determinants of angle opening distance. Determinants of angle width were similar in separate multivariable models for men and women.ConclusionsACD, LV, and IC are the strongest determinants of angle width in Chinese Americans. Sex-related differences in angle width are explained by differences among biometric measurements. These results provide insights into anatomic mechanisms of angle narrowing and have important implications for quantitative assessments of angle closure eyes.

Project description:ObjectiveTo establish a normative database for the vascular density (VD) in macular, disc, and peripapillary regions in healthy myopic children and to evaluate associated ocular features with optical coherence tomography angiography (OCTA).MethodsThis was an observational, prospective and cross-sectional study. 776 Chinese healthy myopic children (375 boys and 401 girls) were enrolled, mean (±SD) age 9.84 ± 1.98 (range 6-16) years. En-face angiogram OCTA was performed on 6 mm × 6 mm retinal and 4.5 mm × 4.5 mm disc regions. VD measurements in the macular retina were segmented into the four regions: superficial capillary plexus (SCP), intermediate capillary plexus (ICP), deep capillary plexus (DCP), and choriocapillaris (CC). Correlations between macular, disc, and peripapillary VD and possible influencing factors [age, gender, axial length (AL), spherical equivalent refraction (SER), right/left eye, and signal strength index (SSI)] were assessed by Pearson's correlation and multivariate regression analysis.ResultsFor macular scans, the corrected VD in the ICP region was (48.25 ± 4.24)% for the whole macular retina. The macular ICP VD in most sections was lower than the SCP, DCP, and CC (all P < 0.001). The corrected VD in CC was (72.96 ± 4.42)% for the whole macular retina. The macular CC VD in every section was all higher than the SCP, ICP, and DCP (all P < 0.001). The size of foveal avascular zone (FAZ) and foveal VD 300 (FD-300) was 0.28 mm2± 0.10 mm2 and (58.43 ± 4.17)% respectively. For disc scans, the corrected VD was (58.04 ± 2.73)% for the whole disc area. Both AL and SER were strongly correlated with ICP, DCP, and CC VD in all regions (all P < 0.01). Larger SSI was correlated with a lower VD in the SCP and ICP, and a higher VD in DCP and CC (all P < 0.01).ConclusionVascular density values provide large scale normative data on macular, disc, and peripapillary vascular parameters in a large sample of healthy myopic children with OCTA measured in the four different retinal plexuses and regions. The VD in different regions had various influencing factors; mainly a close correlation with AL and SSI.

Dataset Information

Systemic Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study.

Publications

Systemic Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study.

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