Evaluation of retinal microvascular perfusion in systemic sclerosis: a case–control study

Rothe, Matthias; Rommel, Felix; Klapa, Sebastian; Humrich, Jens Y; Nieberding, Relana; Lange, Tanja; Sochurek, Jan A M; Plöttner, Pauline; Grisanti, Salvatore; Riemekasten, Gabriela; Ranjbar, Mahdy

doi:10.1136/annrheumdis-2018-214541

Cited by 23 publications

(21 citation statements)

References 6 publications

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“…Our study group previously suggested reduced perfusion of the retina in patients with SSc by using OCTA [14]. Likewise, we found significant impairment of all choroidal sublayers in SSc patients compared to healthy subjects [15].…”

Section: Introductionsupporting

confidence: 70%

“…Each angiogram was exported into ImageJ (NIH, Version 1.48b, Bethesda, USA) and binarized by the Otsu method, which is an automatic threshold selection from grey-level histograms, to determine the percentage of white and black pixels [24]. Superficial retinal perfusion (SRP), deep retinal perfusion (DRP) and full retinal perfusion (FRP), as well as CC perfusion (CCP), were calculated by scoring the percentage of white pixels in relation to the number of total pixels, while for SL perfusion (SLP) and HL perfusion (HLP) the percentage of black pixels was taken into account [14,19,25].…”

Section: Methodsmentioning

confidence: 99%

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Correlation of retinal and choroidal microvascular impairment in systemic sclerosis

Rommel

Prangel

Prasuhn

et al. 2021

Orphanet J Rare Dis

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Purpose To investigate the correlation between retinal and choroidal microperfusion in patients with systemic sclerosis (SSc) using optical coherence tomography angiography (OCTA). Methods In this cross-sectional study SSc patients without clinical evidence of ocular involvement and healthy, age- and sex-matched volunteers were recruited. Participants underwent specific rheumatological and ophthalmological examinations, including optical coherence tomography (OCT) and OCTA. Retinal and choroidal thicknesses as well as perfusion of the retina and the choroidal sublayers were evaluated. Results A total of 15 SSc patients (30 eyes) with a median disease duration of 60 months and 15 matched, healthy controls (30 eyes) were recruited. OCT data revealed a significantly lower macular volume, as well as Sattler’s layer and Haller’s layer thickness in SSc patients compared to controls. In OCTA analysis, the perfusion of both retinal plexus as well as Sattler’s and Haller’s layer were significantly reduced in the SSc group. Patients with a disease duration of more than 60 months showed a statistically significant positive correlation between retinal and choroidal malperfusion, while those with a shorter disease duration did not. Conclusion OCTA analysis confirmed impairment of retinal and choroidal microperfusion in SSc patients, supporting the hypothesis of wide spreading vascular injury. In early stages, either the retinal or the choroidal perfusion seems to be involved, while later on, vascular impairment affects both tissues alike. Both, retinal and choroidal examinations should be considered as soon as the diagnosis of SSc is made, to avoid missing out on early alterations.

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Section: Introductionsupporting

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Correlation of retinal and choroidal microvascular impairment in systemic sclerosis

Rommel

Prangel

Prasuhn

et al. 2021

Orphanet J Rare Dis

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“…The OCT-A measurements were performed at the same time of the day (specifically, 3:00-5:00 pm) in both patients and controls [14,[22][23][24]. Thicknesses at the whole image, foveal, and parafoveal zone were measured by OCT [9,10,25].…”

Section: Methodsmentioning

confidence: 99%

“…In this context, the analysis of increased vascular permeability in retina might be a reasonable tool to explore vasoregulatory aspects of HAE due to C1INH deficiency. Optical Coherent Tomography Angiography (OCT-A) is a noninvasive imaging technique that is able to visualize the retinal microvasculature detecting blood flow without intravenous dye injection [9,10] .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of retinal microvascular perfusion in hereditary angioedema: a case-control study

Triggianese

Cesareo

Guarino

et al. 2020

Orphanet J Rare Dis

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Evidence supports that hereditary angioedema (HAE) may be considered as a paroxysmal permeability disorder with defective but self-limiting endothelial barrier dysfunction. A potential subclinical abnormal vascular permeability at retinal capillaries could induce damage resulting in retinopathy. We aimed at exploring for the first time the presence of microangiopathy at retinal level from a highly selective cohort of patients with HAE due to C1 esterase inhibitor protein (C1INH) deficiency (type I). We conducted a pilot, prospective, case-control study including 20 type I HAE patients and 20 age−/sex-matched healthy controls (HC). All participants underwent standard ophthalmological examination including visual fields. Superficial and deep capillary plexi in the retina were analyzed by using new optical coherence tomography angiography (OCT-A). A total of 40 eyes from 20 HAE patients and 20 eyes from HC were evaluated. Perimetric indices of visual field were slightly worse in HAE than in controls. OCT-angiograms documented in HAE patients a lower retinal capillary density in both superficial and deep scans and a higher retinal thickness compared to healthy eyes. Our findings firstly documented subclinical abnormalities in retinal microvascular network in type I HAE patients that might be associated with early subtle functional changes. This preliminary evidence supports the hypothesis of a recurrent endothelial barrier failure at retinal level in HAE patients potentially resulting in chronic damage.

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“…Each acquired en face image was exported into ImageJ (NIH, Version 1.52e, Bethesda, Rockville, MD, USA) and binarized using the Otsu method, an automatic threshold selection from gray-level histograms, by using the command path Image > Adjust > Threshold > Auto in order to determine the percentage of white and black pixels [22]. As in previous publications, SCP perfusion (SCPP), DCP perfusion (DCPP) and CC perfusion (CCP) were calculated by recording the percentage of white pixels, while for SL perfusion (SLP) and HL perfusion (HLP) black pixels were scored [4,23,24].…”

Section: Methodsmentioning

confidence: 99%

Evaluating Retinal and Choroidal Perfusion Changes After Ocular Massage of Healthy Eyes Using Optical Coherence Tomography Angiography

et al. 2020

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Background and objectives: Ocular massage (OM) is used as a treatment option for acute retinal artery occlusion, under the assumption that it induces vessel dilatation and enhances perfusion. Since evidence of ocular perfusion alteration due to OM is lacking, we investigate the impact of OM on the hemodynamics of the posterior pole in healthy eyes in a noninvasive fashion by using optical coherence tomography angiography (OCTA). Materials and Methods: A prospective study was conducted on healthy volunteers, each of whom underwent measurements of intraocular pressure (IOP), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), radial peripapillary capillary perfusion (RPCP), superficial capillary plexus perfusion (SCPP), deep capillary plexus perfusion (DCPP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP) and Haller’s layer perfusion (HLP) before and after OM. OM was performed for 2 min, consisting of 10-s turns of compression and decompression of the globe. Results: A total of 21 eyes from 21 participants (median age 29) were included. After OM, IOP significantly declined (p < 0.001), while SFCT (p < 0.005), SCPP (p < 0.001), DCPP (p = 0.004) and CCP (p = 0.008) significantly increased. CMT, RPCP, SLP and HLP did not show any significant alteration due to OM. Changes in SCPP correlated positively with changes in CCP and vice versa. Conclusions: OCTA-based analysis in healthy adults following OM demonstrated a significant increase of retinal perfusion values, assumed to be due to failure of autoregulatory mechanisms. These findings may indicate a positive effect of OM as a treatment option for patients with acute retinal artery occlusion.

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Evaluation of retinal microvascular perfusion in systemic sclerosis: a case–control study

Cited by 23 publications

References 6 publications

Correlation of retinal and choroidal microvascular impairment in systemic sclerosis

Correlation of retinal and choroidal microvascular impairment in systemic sclerosis

Evaluation of retinal microvascular perfusion in hereditary angioedema: a case-control study

Evaluating Retinal and Choroidal Perfusion Changes After Ocular Massage of Healthy Eyes Using Optical Coherence Tomography Angiography

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