Optical Coherence Tomography Angiography Reveals Distinct Retinal Structural and Microvascular Abnormalities in Cerebrovascular Disease

Zhang, Xiayin; Xiao, Hui; Liu, Chunxin; Liu, Sanxin; Zhao, Lanqin; Wang, Ruixin; Wang, Jinghui; Wang, Ting; Chen, Chuan; Wu, Xiaohang; Lin, Duoru; Qiu, Wei; Yu‐Wai‐Man, Patrick; Lu, Zhengqi; Lin, Haotian

doi:10.3389/fnins.2020.588515

Cited by 15 publications

(11 citation statements)

References 29 publications

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“…There are increasing evidences that the retina can reflect cerebrovascular and systemic vascular alterations ( 11 – 13 ). The retinal and cerebral microvasculature share physiological and morphological characteristics; therefore, the clinical assessment of retinal vessels could be a potential marker of the state of the cerebrovasculature.…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Angiography for the Evaluation of Retinal Vasculature in Fabry Disease: Our Experience and Review of Current Knowledge

et al. 2021

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Purpose: Optical coherence tomography angiography (OCTA) is a non-invasive and objective tool for the evaluation of the retinal microvascular changes in Fabry disease (FD). We investigated changes in retinal vasculature in FD patients, and the possible correlation with systemic parameters, by using OCTA, and reviewed the current status of literature.Methods: Thirteen FD patients (eight females, five males, mean age 49.85 ± 14.7 years) were compared with 13 age- and sex-matched healthy controls. OCTA 3 × 3 mm macular scans were performed in all subjects. We evaluated the vessel density and vessel perfusion in distinct macular areas (whole, inner, and outer) of both the superficial capillary plexus (SCP VD and SCP VP) and of the deep capillary plexus (DCP VD and DCP VP). We also evaluated the foveal avascular zone (FAZ) metrics (area, perimeter, and circularity), and correlation between systemic and OCTA parameters. A literature review on the current understanding of OCTA in FD is then presented.Results: FD patients showed significantly lower SCP VD values in the whole area (17.37 ± 2.08 mm−1 vs. 18.54 ± 1.21 mm−1; p-value 0.022), as well as in the outer area (17.46 ± 2.10 mm−1 vs. 19.08 ± 1.14 mm−1; p-value 0.002), but not in the inner. Even the DCP VD was significantly lower in all the imaged areas: whole (17.75 ± 3.93 mm−1 vs. 19.71 ± 1.20 mm−1; p-value 0.024), outer (18.25 ± 4.17 mm−1 vs. 20.33 ± 1.20 mm−1; p-value 0.023), and inner (19.54 ± 4.17 mm−1 vs. 21.96 ± 1.55 mm−1; p-value 0.011). There were no significant differences in vessel perfusion parameters (both SCP VP and DCP VP ones) and FAZ. No significant correlations were found between the OCTA parameters and systemic parameters (maximal left ventricular wall thickness and glomerular filtration rate) in FD patients.Conclusions: OCTA can be considered as a promising non-invasive tool, which enables a quantitative evaluation of retinal vascular involvement in FD, despite the varying data reported in literature. Our results support the use of OCTA as an objective tool to evaluate retinal vascular abnormalities in FD. The utility of OCTA in FD needs to be validated by longitudinal studies taking into account the overall progression of the disease.

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Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Angiography for the Evaluation of Retinal Vasculature in Fabry Disease: Our Experience and Review of Current Knowledge

et al. 2021

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“…On the other hand, OCT studies found that retinal neural damage occurs with microvascular rarefication 28 . The cerebrovascular disease can be identified for its distinct neurovascular alteration pattern on the retina 40 . Hence, further exploration is required to uncover the specificity of OCTA on detecting CVDs fully.…”

Section: Discussionmentioning

confidence: 99%

Detection of Systemic Diseases From Ocular Images Using Artificial Intelligence: A Systematic Review

Peng

Tseng

Tham

et al. 2022

Asia-Pacific Journal of Ophthalmology

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Purpose: Despite the huge investment in health care, there is still a lack of precise and easily accessible screening systems. With proven associations to many systemic diseases, the eye could potentially provide a credible perspective as a novel screening tool. This systematic review aims to summarize the current applications of ocular image–based artificial intelligence on the detection of systemic diseases and suggest future trends for systemic disease screening. Methods: A systematic search was conducted on September 1, 2021, using 3 databases—PubMed, Google Scholar, and Web of Science library. Date restrictions were not imposed and search terms covering ocular images, systemic diseases, and artificial intelligence aspects were used. Results: Thirty-three papers were included in this systematic review. A spectrum of target diseases was observed, and this included but was not limited to cardio-cerebrovascular diseases, central nervous system diseases, renal dysfunctions, and hepatological diseases. Additionally, one- third of the papers included risk factor predictions for the respective systemic diseases. Conclusions: Ocular image – based artificial intelligence possesses potential diagnostic power to screen various systemic diseases and has also demonstrated the ability to detect Alzheimer and chronic kidney diseases at early stages. Further research is needed to validate these models for real-world implementation.

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“…OCTA imaging was performed using an ultra‐clear OCT and AngioPlex device (Cirrus 5,000, version 10.0; Zeiss Meditec, California, USA) as described previously. (Zhang, Xiao, Liu, Liu, et al., 2020; Zhang, Xiao, Liu, Zhao, et al., 2020) Briefly, we selected an optic disc cube 200 × 200 scan protocol for pRNFL measurements. pRNFL thickness was measured within 3.46‐mm‐diameter circles around the optic disc.…”

Section: Methodsmentioning

confidence: 99%

Optical coherence tomography angiography helps distinguish multiple sclerosis from AQP4‐IgG‐seropositive neuromyelitis optica spectrum disorder

et al. 2021

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Introduction The aim was to characterize the optical coherence tomography (OCT) angiography measures in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) and to evaluate their disease discrimination capacity. Methods Patients with MS (n = 83) and AQP4‐IgG‐seropositive NMOSD (n = 91) with or without a history of optic neuritis, together with healthy controls (n = 34), were imaged. The main outcome measures were peripapillary retinal nerve fiber layer (pRNFL) thickness, macular ganglion cell‐inner plexiform layer (GC‐IPL) thickness, macular vessel density (VD), and perfusion density (PD) in the superficial capillary plexus. Diagnostic accuracy was assessed using the area under the receiver operating characteristics curve. Results Compared with patients with MS, those with NMOSD had a significantly smaller average thickness of the pRNFL and GC‐IPL (80.0 [59.0; 95.8] μm versus 92.0 [80.2; 101] μm, p < .001; 68.0 [56.0; 81.0] μm, versus 74.5 [64.2; 81.0] μm, p < .001) and significantly smaller whole VD and PD areas (15.6 [12.6; 17.0] mm−1 versus 16.7 [14.8; 17.7] mm−1, p < .001; 0.38 [0.31; 0.42] mm−1 versus 0.40 [0.37; 0.43] mm−1, p < .01). The combination of structural parameters (average thickness of the pRNFL and GC‐IPL) with microvascular parameters (temporal‐inner quadrant of VD, temporal‐inner, nasal‐inferior, and nasal‐outer quadrant of PD) was revealed to have a good diagnostic capability for discriminating between NMOSD and MS. Conclusions OCT angiography reveals different structural and microvascular retinal changes in MS and AQP4‐IgG‐seropositive NMOSD. These combined structural and microvascular parameters might be promising biomarkers for disease diagnosis.

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Optical Coherence Tomography Angiography Reveals Distinct Retinal Structural and Microvascular Abnormalities in Cerebrovascular Disease

Cited by 15 publications

References 29 publications

Optical Coherence Tomography Angiography for the Evaluation of Retinal Vasculature in Fabry Disease: Our Experience and Review of Current Knowledge

Optical Coherence Tomography Angiography for the Evaluation of Retinal Vasculature in Fabry Disease: Our Experience and Review of Current Knowledge

Detection of Systemic Diseases From Ocular Images Using Artificial Intelligence: A Systematic Review

Optical coherence tomography angiography helps distinguish multiple sclerosis from AQP4‐IgG‐seropositive neuromyelitis optica spectrum disorder

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