Retinal Blood Velocity and Flow in Early Diabetes and Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy

Palochak, Cherilyn Mae A.; Lee, Hee Eun; Song, Jessica; Geng, Andrew; Linsenmeier, Robert A.; Burns, Stephen A.; Fawzi, Amani A.

doi:10.3390/jcm8081165

Cited by 56 publications

(52 citation statements)

References 47 publications

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“…Other velocity measurements, such as those using targeted dye delivery, found vessels between 20 µm to 80 µm to exhibit power law exponents of 2.90, less than that predicted by Murray's law though larger than the values found here 21 . AOSLO measurements for larger vessels using a different technique also found an exponent closer to 3 43 . We do expect deviations from Murray's law for small vessels for a number of reasons.…”

Section: Discussionmentioning

confidence: 73%

Full-field flicker evoked changes in parafoveal retinal blood flow

Warner

Castro

Sawides

et al. 2020

Sci Rep

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When retinal activity is increased by exposure to dynamic visual stimuli, blood vessels dilate and the flow of blood within vessels increases to meet the oxygen and glucose demands of the neurons. This relationship is termed ‘neurovascular coupling’ and it is critical for regulating control of the human retinal vasculature. In this study, we used a recently developed technique based on a dual-beam adaptive optics scanning laser ophthalmoscope to measure changes in red blood cell velocities, vessel diameter, and flow in interconnected small parafoveal retinal vessels (< 50 µm) of nine healthy participants. A full-field flicker stimulus was presented onto the retina to induce a vascular response to neural activity. Flicker stimulation increased blood velocity, vessel diameter, and therefore flow in arterioles, capillaries, and venules in all nine subjects. ANOVA and post hoc t-test showed significant increases in velocity and flow in arterioles and venules. These measurements indicate that the mechanism of neurovascular coupling systematically affects the vascular response in small retinal vessels in order to maintain hemodynamic regulation in the retina when exposed to visual stimulation, in our case flicker. Our findings may provide insight into future investigations on the impairments of neurovascular coupling from vascular diseases such as diabetic mellitus.

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Section: Discussionmentioning

confidence: 73%

Full-field flicker evoked changes in parafoveal retinal blood flow

Warner

Castro

Sawides

et al. 2020

Sci Rep

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“…[19][20][21][81][82][83][84][85][86][87] Except for the biochemical changes, physiological changes also play a role in the process of DR. Hemodynamic dysfunction has been found in DR and may precede clinical DR. [88][89][90][91][92] Hemodynamic parameters, wall shear rate and wall shear stress are suggested reduced in the early stage of DR, as well as retinal blood velocity and ow, which could be markers of microvasculopathy. 88,93,94 Atherosclerosis has also been considered associated with the severity of DR, manifesting increased macrovascular artery intima-media wall thickness and accompanied by wider retinal vessel diameter in DR. [95][96][97] These studies emphasize the vital role of hemodynamic changes in the early stage of DR. CDDP in TCM theory is characterized by improving blood circulation (Pharmacopoeia of the People's Republic of China). The early application of CDDP in NPDR patients can signi cantly shorten the retinal circulation time and reduce capillary hemangioma, hard exudates, retinal hemorrhaging.…”

Section: Discussionmentioning

confidence: 99%

A Network Pharmacology Based Analysis of The Potential Mechanisms of Compound Danshen Dripping Pill for Treatment of Diabetic Retinopathy

Zhang¹,

Wang²,

Huang³

et al. 2020

Preprint

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Background: Diabetic retinopathy (DR) has become a worldwide concern in recent years because of the high prevalence and vision-threat. The limited therapies have been in stark contrast to its high prevalence. On top of that, almost all the treatments, like laser, are applied only at the end stage of this disease. However, with the development of network pharmacology, a traditional Chinese medicine (TCM), Compound Danshen Dripping Pill (CDDP), may bring some new insights into the early intervention of DR. Methods: The active compounds and potential targets of CDDP and DR-related targets were collected from the TCMSP, UniProt, GeneCards and OMIM databases. And protein-protein interactions (PPI) information was achieved from the STRING database. The gene enrichment analysis of GO and KEGG was carried out by “clusterProfiler” in R software. The collected data was then used to form network maps of compound-target and PPI, or visualized by the software of Cytoscape. Results: 54 compounds and 50 targets were identified for CDDP against DR. Among the predicted effective compounds, 29 tanshinones from Radix Salviae (Danshen) were identified. And the core targets might be estrogen receptor (ESR1), androgen receptor (AR), caspase-3 (CASP3), Interleukin-6 (IL6) and vascular endothelial growth factor A (VEGFA) in 50 targets. There were 266 significantly correlated biological processes such as steroid hormone response, oxidative stress and apoptosis enriched out. Besides, The 50 targets significantly participate in 97 pathways and mainly enriched in advanced glycation end products (AGE)-receptor for advanced glycation end products (RAGE), fluid shear stress and atherosclerosis, apoptosis and VEGF signal pathway et al.Conclusions: The mechanisms of CDDP for treating DR may involve multi-compound, multi-target and multi-pathway synergistic effects. It may participate in the regulation of steroid hormone response, oxidative stress, apoptosis and hemodynamics in diabetic retina. Tanshinones and luteolin from Radix Salviae were probably responsible for the effectiveness of CDDP on DR.

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“…It is less well-established how retinal blood flow under resting conditions behaves in diabetes and DR. Evidence for both increased [44][45][46][47][48][49] and decreased retinal blood flow [50][51][52][53][54] have been reported in diabetes and early DR. A recent study suggested that the increased retinal blood flow is a consequence of early retinal hypoxia [49], which is associated with retinal vasodilatation [55,56].…”

Section: Ocular Vascular Changes In Diabetesmentioning

confidence: 99%

Optical Coherence Tomography Angiography in Diabetes and Diabetic Retinopathy

Chua

Sim

Tan

et al. 2020

JCM

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Diabetic retinopathy (DR) is a common complication of diabetes mellitus that disrupts the retinal microvasculature and is a leading cause of vision loss globally. Recently, optical coherence tomography angiography (OCTA) has been developed to image the retinal microvasculature, by generating 3-dimensional images based on the motion contrast of circulating blood cells. OCTA offers numerous benefits over traditional fluorescein angiography in visualizing the retinal vasculature in that it is non-invasive and safer; while its depth-resolved ability makes it possible to visualize the finer capillaries of the retinal capillary plexuses and choriocapillaris. High-quality OCTA images have also enabled the visualization of features associated with DR, including microaneurysms and neovascularization and the quantification of alterations in retinal capillary and choriocapillaris, thereby suggesting a promising role for OCTA as an objective technology for accurate DR classification. Of interest is the potential of OCTA to examine the effect of DR on individual retinal layers, and to detect DR even before it is clinically detectable on fundus examination. We will focus the review on the clinical applicability of OCTA derived quantitative metrics that appear to be clinically relevant to the diagnosis, classification, and management of patients with diabetes or DR. Future studies with longitudinal design of multiethnic multicenter populations, as well as the inclusion of pertinent systemic information that may affect vascular changes, will improve our understanding on the benefit of OCTA biomarkers in the detection and progression of DR.

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Retinal Blood Velocity and Flow in Early Diabetes and Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy

Cited by 56 publications

References 47 publications

Full-field flicker evoked changes in parafoveal retinal blood flow

Full-field flicker evoked changes in parafoveal retinal blood flow

A Network Pharmacology Based Analysis of The Potential Mechanisms of Compound Danshen Dripping Pill for Treatment of Diabetic Retinopathy

Optical Coherence Tomography Angiography in Diabetes and Diabetic Retinopathy

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