Retinal Changes in Different Grades of Retinal Artery Occlusion: An Optical Coherence Tomography Study

Furashova, Olga; Matthé, Egbert

doi:10.1167/iovs.17-22411

Cited by 37 publications

(32 citation statements)

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“…After this phase of retinal thickening due to a shortage of oxygen in the acute stage of CRAO, all retinal layers are reduced in thickness measured with OCT. 191 The thickness of especially inner and middle retinal layers is described to remain reduced late after CRAO. 192 First time-resolved fluorescence examinations in retinal artery occlusions were conducted with an experimental setup and published by Schweitzer et al 101,193 Of special interest were BRAOs, as in these eyes perfused and nonperfused areas could be compared. CRAOs were investigated as well.…”

Section: Retinal Artery Occlusionmentioning

confidence: 99%

Review of clinical approaches in fluorescence lifetime imaging ophthalmoscopy

et al. 2018

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Autofluorescence-based imaging techniques have become very important in the ophthalmological field. Being noninvasive and very sensitive, they are broadly used in clinical routines. Conventional autofluorescence intensity imaging is largely influenced by the strong fluorescence of lipofuscin, a fluorophore that can be found at the level of the retinal pigment epithelium. However, different endogenous retinal fluorophores can be altered in various diseases. Fluorescence lifetime imaging ophthalmoscopy (FLIO) is an imaging modality to investigate the autofluorescence of the human fundus in vivo. It expands the level of information, as an addition to investigating the fluorescence intensity, and autofluorescence lifetimes are captured. The Heidelberg Engineering Spectralis-based fluorescence lifetime imaging ophthalmoscope is used to investigate a 30-deg retinal field centered at the fovea. It detects FAF decays in short [498 to 560 nm, short spectral channel (SSC) and long (560 to 720 nm, long spectral channel (LSC)] spectral channels, the mean fluorescence lifetimes (τm) are calculated using bi- or triexponential approaches. These are meant to be relatively independent of the fluorophore's intensity; therefore, fluorophores with less intense fluorescence can be detected. As an example, FLIO detects the fluorescence of macular pigment, retinal carotenoids that help protect the human fundus from light damages. Furthermore, FLIO is able to detect changes related to various retinal diseases, such as age-related macular degeneration, albinism, Alzheimer's disease, diabetic retinopathy, macular telangiectasia type 2, retinitis pigmentosa, and Stargardt disease. Some of these changes can already be found in healthy eyes and may indicate a risk to developing such diseases. Other changes in already affected eyes seem to indicate disease progression. This review article focuses on providing detailed information on the clinical findings of FLIO. This technique detects not only structural changes at very early stages but also metabolic and disease-related alterations. Therefore, it is a very promising tool that might soon be used for early diagnostics.

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Section: Retinal Artery Occlusionmentioning

confidence: 99%

Review of clinical approaches in fluorescence lifetime imaging ophthalmoscopy

et al. 2018

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“…Autologous transplantation in human patients would allow addressing some of the basic questions about photoreceptors survival and rewiring, without the confounding factors of histocompatibility. In addition, if removal of the inner retinal cells prior to transplantation would facilitate integration, that could be induced regionally by branch arterial occlusion with laser 40…”

Section: Discussionmentioning

confidence: 99%

Transplantation of Mature Photoreceptors in Rodents With Retinal Degeneration

Lorach

Kang

Bhuckory

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose To demonstrate survival and integration of mature photoreceptors transplanted with the retinal pigment epithelium (RPE). Methods Full-thickness retina with attached RPE was harvested from healthy adult rats. Grafts were implanted into two rat models of retinal degeneration, Royal College of Surgeons (RCS) and S334ter-3. Survival of the host and transplanted retina was monitored using optical coherence tomography (OCT) for up to 6 months. The retinal structure and synaptogenesis between the host and transplant was assessed by histology and immunohistochemistry. Results OCT and histology demonstrated a well-preserved photoreceptor layer with inner and outer segments, while the inner retinal layers of the transplant largely disappeared. Grafts, including RPE, survived better than without and the transplanted RPE appeared as a monolayer integrated with the native one. Synaptogenesis was observed through sprouting of new dendrites from the host bipolar cells and synaptic connections forming with cells of the transplant. However, in many samples, a glial fibrillary acidic protein–positive membrane separated the host retina and the graft. Conclusions Presence of RPE in the graft improved the survival of transplanted photoreceptors. Functional integration between the transplant and the host retina is likely to be further enhanced if formation of a glial seal could be prevented. Transplantation of the mature photoreceptors with RPE may be a practical approach to restoration of sight in retinal degeneration. Translational Relevance This approach to restoration of sight in patients with photoreceptor degeneration can be rapidly advanced to clinical testing. In patients with central scotoma, autologous transplantation of the peripheral retina can be an option.

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“…We previously reported a novel method of assessment for acute retinal ischemia in retinal artery occlusion disease 17 -we could find strong differences in retinal layers' reflectivity depending on the extent of acute retinal ischemia. In the present study, we applied the same method to measure the possible acute ischemic damage in cases of retinal vein occlusion disease.…”

Section: Dovepressmentioning

confidence: 94%

“…[12][13][14][15][16] In our previous study, we could also show that retinal ischemia in acute retinal artery occlusion results in hyperreflectivity of inner retinal layers, which is significantly different depending on the disease grade and might therefore be used to assess the grade of acute ischemic damage to the retina. 17,18 Regarding the need for a stable, objective, and easily measurable parameter with strong probability value for severe RVO course, we analyzed the hyperreflectivity of selected retinal layers in acute RVO as a value of acute ischemic retinal damage and measured its correlation with other known RVO severity parameters.…”

Section: Introductionmentioning

confidence: 99%

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<p>Hyperreflectivity of Inner Retinal Layers as a Quantitative Parameter of Ischemic Damage in Acute Retinal Vein Occlusion (RVO): An Optical Coherence Tomography Study</p>

Furashova¹,

Matthé²

2020

OPTH

Self Cite

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Purpose: To investigate the reflectivity changes of inner retinal layers in acute retinal vein occlusion (RVO) on spectral-domain optical coherence tomography (SD-OCT) and to correlate these values with other known parameters of acute ischemic damage. Patients and Methods: In this retrospective and observational case series, 230 eyes from 115 patients with acute RVO (central or branch) were categorized as ischemic or nonischemic depending on fluorescein angiography (FA) images at baseline. Thickness and reflectivity of selected retinal layers were measured from SD-OCT images at baseline. Reflectivity values were correlated with other parameters of acute ischemic damage (bestcorrected visual acuity (BCVA), retinal thickness, extent of macular edema, ischemic area on fluorescein angiography). The data were compared with contralateral eyes (controls). Prominent middle limiting membrane sign (p-MLM) was also registered. Results: RVO reflectivity values differed significantly in all retinal layers compared to controls (P<0.001). Ischemic RVO eyes had higher optical intensity values for the innermost retinal layer (IMRL; P=0.008) and inner retinal layer (P=0.019) compared to non-ischemic cases. For all RVO eyes as well as central RVO, severity parameters like BCVA, central and total retinal thickness showed a strong correlation with the IMRL reflectivity. In branch RVO, BCVA remained significantly correlated with the IMRL reflectivity, while the thickness values showed significant correlation only for central foveal thickness in non-ischemic branch RVO type. The p-MLM was seen on OCT in 94% of the ischemic and in 66% of the non-ischemic RVO cases. Conclusion: Acute RVO leads to increased reflectivity of inner retinal layers with significantly higher values in the ischemic vs non-ischemic type. Increased inner retinal layers' reflectivity correlated significantly with BCVA, retinal thickness of separate retinal layers, as well as ischemic area on FA. Quantitative non-invasive measurement of inner retinal layers' reflectivity might be used to determine the extent of acute ischemic retinal damage in RVO.

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Retinal Changes in Different Grades of Retinal Artery Occlusion: An Optical Coherence Tomography Study

Abstract: The reflectivity changes of selected retinal layers differ significantly regarding different grades of RAO. SD-OCT reflectivity measurement may be used as a noninvasive method to estimate the grade of retinal ischemia in RAO.

Cited by 37 publications

References 20 publications

Review of clinical approaches in fluorescence lifetime imaging ophthalmoscopy

Review of clinical approaches in fluorescence lifetime imaging ophthalmoscopy

Transplantation of Mature Photoreceptors in Rodents With Retinal Degeneration

<p>Hyperreflectivity of Inner Retinal Layers as a Quantitative Parameter of Ischemic Damage in Acute Retinal Vein Occlusion (RVO): An Optical Coherence Tomography Study</p>

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