Higher retinal vessel oxygen saturation: investigating its relationship with macular oedema in retinitis pigmentosa patients

Bojinova, R. I.; Valmaggia, Christophe; Türksever, Cengiz; Schoetzau, Andreas; Todorova, Margarita G.

doi:10.1038/s41433-018-0043-1

Cited by 20 publications

(24 citation statements)

References 44 publications

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“…These findings were more pronounced in patients with rod-cone dystrophy (RCD) [ 38 , 39 , 40 ]. Furthermore, the oxygen saturation values correlated well with structural and functional changes [ 39 , 41 , 42 , 43 ]. In addition, peripapillary retinal vessel diameters were reduced proportionally to the functional and structural changes [ 39 , 44 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the amount of peripapillary RNFL structural changes correlates well with the metabolic alterations detected by RO in IRDs [ 39 ]. In addition, the presence of cystoid macular edema (CME) in OCT imaging, reported to occur in 10%–50% of retinitis pigmentosa patients [ 51 , 52 , 53 , 54 ], has been well associated with the best-corrected visual acuity [ 55 , 56 ] and also with the degree of metabolic alterations and foveal vascular anomalies in RCD [ 42 , 57 ].…”

Section: Introductionmentioning

confidence: 99%

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Retinal Oxygenation in Inherited Diseases of the Retina

Türksever

Torres

Valmaggia

et al. 2021

Genes

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(1) Background: The aim of our study was to investigate the relationship between retinal metabolic alterations (retinal vessel oximetry, RO) and structural findings (retinal vessel diameter, central retinal thickness and retinal nerve fiber layer thickness, RNFL) in patients with inherited retinal diseases (IRDs). (2) Methods: A total of 181 eyes of 92 subjects were examined: 121 eyes of 62 patients with IRDs were compared to 60 eyes of 30 healthy age-matched controls. The retinal vessel oximetry was performed with the oxygen saturation measurement tool of the Retinal Vessel Analyser (RVA; IMEDOS Systems UG, Jena, Germany). The oxygen saturation in all four major peripapillary retinal arterioles (A-SO2; %) and venules (V-SO2; %) were measured and their difference (A-V SO2; %) was calculated. Additionally, retinal vessel diameters of the corresponding arterioles (D-A; µm) and venules (D-V; µm) were determined. The peripapillary central retinal thickness and the RNFL thickness were measured using spectral domain optical coherence tomography (SD-OCT) (Carl Zeiss Meditec, Dublin, CA, USA). Moreover, we calculated the mean central retinal oxygen exposure (cO2-E; %/µm) and the mean peripapillary oxygen exposure (pO2-E; %/µm) per micron of central retinal thickness and nerve fiber layer thickness by dividing the mean central retinal thickness (CRT) and the RNFL thickness with the mean A-V SO2. (3) Results: Rod-cone dystrophy patients had the highest V-SO2 and A-SO2, the lowest A-V SO2, the narrowest D-A and D-V and the thickest RNFL, when compared not only to controls (p ≤ 0.040), but also to patients with other IRDs. Furthermore, in rod-cone dystrophies the cO2-E and the pO2-E were higher in comparison to controls and to patients with other IRDs (p ≤ 0.005). Cone-rod dystrophy patients had the lowest cO2-E compared to controls and patients with other IRDs (p ≤ 0.035). Evaluated in central zones, the cO2-E was significantly different when comparing cone-rod dystrophy (CRD) against rod-cone dystrophy (RCD) patients in all zones (p < 0.001), whereas compared with controls and patients with inherited macular dystrophy this was observed only in zones 1 and 2 (p ≤ 0.018). The oxygen exposure was also the highest in the RCD group for both the nasal and the temporal peripapillary area, among all the evaluated groups (p ≤ 0.025). (4) Conclusions: The presented metabolic-structural approach enhances our understanding of inherited photoreceptor degenerations. Clearly demonstrated through the O2-E comparisons, the central and the peripapillary retina in rod-cone dystrophy eyes consume less oxygen than the control-eyes and eyes with other IRDs. Rod-cone dystrophy eyes seem to be proportionally more exposed to oxygen, the later presumably leading to more pronounced oxidative damage-related remodeling.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retinal Oxygenation in Inherited Diseases of the Retina

Türksever

Torres

Valmaggia

et al. 2021

Genes

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“…Previous studies on the application of RO in patients with IRDs showed the oxygenation in retinal vessels of the inner retina to be affected (Eysteinsson et al 2014; Todorova et al 2014; Türksever et al 2014; Battu et al 2015; Ueda‐Consolvo et al 2015; Todorova et al 2016; Zong et al 2016; Bojinova et al 2017; Todorova 2017; Bojinova et al 2018; Waizel et al 2018a), thus confirming an altered metabolic function as a result of a degenerative process of the outer retina. For rod–cone dystrophies, strong correlations have been found between the retinal metabolic demand and the structural (Türksever et al 2014; Bojinova et al 2017; Bojinova et al 2018) and functional alterations (Todorova et al 2016; Bojinova et al 2018). Even if not applicable in children, transcorneal electrical stimulation is currently the only evidence‐based therapeutic modality in elderly RCD patients with visual acuity over light perception, where RO has already confirmed its value to serve as an objective and sensitive monitoring method (Della Volpe‐Waizel et al 2020).…”

Section: Introductionmentioning

confidence: 99%

Retinal vessel oximetry in children with inherited retinal diseases

Waizel

Scholl

Valmaggia

et al. 2020

Acta Ophthalmologica

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Background Retinal vessel oximetry (RO) has been used to show altered metabolic function in patients with inherited retinal diseases (IRDs). The aim of this study was to investigate RO parameters of children with IRDs and presumed IRD carriers (pIRDc) and to compare them to controls. Methods In this cross‐sectional cohort study, 142 eyes from 71 Caucasian subjects were included: 40 eyes with IRDs, 26 eyes with pIRDc and 76 control eyes. The oxygen saturation was measured with the Retinal Vessel Analyser (IMEDOS Systems UG, Jena, Germany). Mean oxygen saturations in the peripapillary retinal arterioles (A‐SO2; %) and venules (V‐SO2; %) were estimated, and their difference (A‐V SO2; %) was calculated. In addition, we evaluated the mean diameter in all major retinal arterioles (D‐A; μm) and venules (D‐V; μm). anova‐based linear mixed‐effects models were calculated with SPSS®. Results In general, children suffering from IRDs differed from controls when the A‐SO2 and A‐V SO2 were taken into account: both the A‐SO2 and the A‐V SO2 were significantly increased (p = 0.012). In subgroup analyses, children suffering from rod–cone dystrophy (RCD) presented an A‐SO2 increase (99.12 ± 8.24%) when compared to controls (91.33 ± 10.34%, p = 0.014) and pIRDc (92.37 ± 6.57%, p = 0.065). For V‐SO2 significant changes in RCD (67.42 ± 9.19%) were found in comparison with controls (58.24 ± 11.74%, p < 0.041), pIRDc (56.67 ± 7.16%, p = 0.007), cone–rod dystrophies (CRD, 52.17 ± 5.32%, p < 0.001) and inherited macular dystrophies (IMD, 55.74 ± 6.96%, p = 0.004), In addition, A‐V SO2 was decreased in RCD (31.69 ± 3.92%) when measured against CRD (41.9 ± 8.87%, p = 0.017) or IMD (39.52 ± 8.95%, p = 0.059). Conclusion In general, we found that children with IRDs presented early metabolic changes. Within IRDs, children with RCD showed more affected metabolic changes. Thus, RO may support early screening to rule out IRDs in children, and more precisely may help to differentiate those suffering from RCD.

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“…It is known that changes of the retinal vasculature with vessel attenuation are a hallmark of RP [4][5][6][7][8][9][10][11]. In this context, swept-source coherence tomography angiography (OCTA) that allows for a non-invasive depth-resolved visualisation of the retinal and choroidal microvasculature in vivo might be useful as a monitoring method for TES treatment.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

Zabek

Zuche

Müller

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose Transcorneal electrical stimulation (TES) is a novel treatment approach for patients with retinitis pigmentosa (RP). The aim of our study was to observe changes in optical coherence tomography angiography (OCTA) that would be attributed to TES treatment. Methods A total of 73 eyes were included: 43 eyes of 22 subjects (11 ♀, 11 ♂) suffering from RP were examined at baseline (BL), after first stimulation (TS), 1 week (1W), and 6 months (6M) after treatment initiation and were compared with 30 control eyes of 15 subjects (8 ♀, 7 ♂). TES was performed simultaneously on both eyes for 30 min weekly. OCTA scans of 9 × 15 mm were recorded with a PLEX Elite 9000 swept-source OCTA device (Carl Zeiss Meditec AG, Jena). Vascular density metrics such as perfusion density (PD) and vessel density (VD) were calculated automatically for the macular area by using standardised extended early treatment diabetic retinopathy study (ETDRS) grids centred around the fovea. In addition, the capillary perfusion density (CPD) and the capillary flux index (CFI) of the peripapillary nerve fibre layer microvasculature in all four quadrants of an annulus centred at the optic disc were measured. All parameters were determined over all retinal layers and separately for the superficial (SCP) and deep capillary plexus (DCP). ANOVA-based linear mixed-effects models were calculated with SPSS®. Results Throughout the course of TES treatment, the macular VD and PD of all retinal layers in all subsections showed a slight decrement without reaching statistical significance, also when analysed separately in the SCP and DCP (p > 0.08). In analogy, the average CPD and CFI also presented with a slight decrement (p > 0.20). However, when compared with controls, most OCTA parameters showed a significant decrement (p < 0.05). When analysed systematically in all subsections of the extended ETDRS grid, the temporal macular subsections within the outer ring (radius 1.5–3 mm) and also of the peripheral C1, C2, and C3 rings (radius 3–7.5 mm) showed lower VD and PD values when compared with the other subsections (p < 0.05). Conclusion Vascular density metrics in the macular region and the peripapillary microvasculature appear to remain unaffected by continuous TES treatment within a period of 6 months.

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Higher retinal vessel oxygen saturation: investigating its relationship with macular oedema in retinitis pigmentosa patients

Abstract: Based on our results, the presence of macular oedema indicates a tendency toward greater alteration of the metabolic function in RP patients.

Cited by 20 publications

References 44 publications

Retinal Oxygenation in Inherited Diseases of the Retina

Retinal Oxygenation in Inherited Diseases of the Retina

Retinal vessel oximetry in children with inherited retinal diseases

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

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