Retinal microvasculature impairment in patients with congenital heart disease investigated by optical coherence tomography angiography

Liu, Cong; Zhong, Pingting; Yuan, Haiyun; Dong, Xiao; Peng, Qingsheng; Huang, Manqing; Wu, Qiaowei; Xu, Mai; Kuang, Yu; Zeng, Xiaomin; Xiao, Yu; Fang, Ying; Yu, Honghua; Yang, Xiaohong

doi:10.1111/ceo.13846

Cited by 16 publications

(13 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, retina is highly sensitive to hypoperfusion and hypoxia. It is found that the retinal VD is decreased in hypertension (Lee et al, 2019 ), coronary heart disease (Wang et al, 2019 ), congenital heart disease (Li et al, 2020 ), obstructive sleep apnea syndrome (Moyal et al, 2018 ), etc. Similarly, in the current study, we also observed a significantly reduced retinal VD in patients with stroke.…”

Section: Discussionmentioning

confidence: 99%

Reduced Retinal Microvascular Perfusion in Patients With Stroke Detected by Optical Coherence Tomography Angiography

Xiao

et al. 2021

Front. Aging Neurosci.

Self Cite

View full text Add to dashboard Cite

Currently there is a shortage of biomarkers for stroke, one of the leading causes of death and disability in aging populations. Retinal vessels offer a unique and accessible “window” to study the microvasculature in vivo. However, the relationship between the retinal microvasculature and stroke is not entirely clear. To investigate the retinal microvascular characteristics in stroke, we recruited patients with stroke and age-matched control subjects from a tertiary hospital in China. The macular vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ) metrics, and optical coherence tomography angiography (OCTA) measured optic disc VD were recorded for analysis. A total of 189 patients with stroke and 195 control subjects were included. After adjusting for sex, visual acuity, systolic and diastolic blood pressure, a history of smoking, levels of hemoglobulin (HbA1c), cholesterol, and high-density lipoprotein (HDL), the macular VD of SCP and DCP in all sectors was decreased in patients with stroke. In the stroke group, the VD around the FAZ and the VD of the optic disk were lower. Logistic regression found the parafovea-superior-hemi VD of DCP > 54.53% [odds ratio (OR): 0.169] as a protective factor of stroke. Using the integration of all OCTA parameters and traditional risk factors, the area under the receiver operating characteristic (AUC) curve of distinguishing patients with stroke was 0.962, with a sensitivity of 0.944 and a specificity of 0.871. Our study demonstrates that the retinal VD is decreased in patients with stroke independently of the traditional risk factors of stroke, which may shed light on the monitoring of stroke using the retinal microvascular parameters.

show abstract

Section: Discussionmentioning

confidence: 99%

Reduced Retinal Microvascular Perfusion in Patients With Stroke Detected by Optical Coherence Tomography Angiography

Xiao

et al. 2021

Front. Aging Neurosci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Additionally, a decrease in wholeVD, foveaVD, and parafovealVD in the choroid capillaries was noted. In contrast, Li et al [ 45 ] analyzed VD in 117 patients with congenital heart disease (CD); 60 of them had acyanotic congenital heart disease (ACD), and 57 had cyanotic congenital heart disease (CCD). The authors noted a significant difference in vascular density: wholeVD ( p = 0.010) and perifovealVD ( p = 0.004) in SP in CCD patients compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

“…The findings of this current study—that cardiovascular disease can lower vascular density—are in keeping with the findings of the above-referenced studies conducted earlier. It is believed that peripheral vasoconstriction in response to low cardiac output is the pathophysiological mechanism that triggers this outcome [ 39 , 43 , 45 ]. Almeida–Freitas et al [ 47 ] recorded higher resistance index and lower diastolic velocity in the ocular arteries of patients with low LVEF.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

Rakusiewicz

Kanigowska

Hautz

et al. 2021

JCM

View full text Add to dashboard Cite

(1) Introduction: The aim of this study is to assess retinal vessel density (VD) in the superficial capillary plexus layer (SP) and deep capillary plexus layer (DP) in children with chronic heart failure (CHF) in the course of dilated cardiomyopathy (DCM) using optical coherence tomography angiography (OCTA). (2) Methods: Thirty children with CHF due to DCM lasting more than six months, with an enlarged left ventricle and impaired left ventricular systolic function (left ventricular ejection fraction (LVEF) ≤ 55%), were enrolled to have both their eyes assessed for this study. Mean age of the children was 9.9 ± 3.57 years. The control group consisted of an additional 30 children without CHF (mean age 11.27 ± 3.33 years) matched for age and gender against the study group. All participants underwent transthoracic echocardiography to measure LVEF using Simpson method. Blood serum was tested for N-terminal-pro-brain natriuretic peptide (NT-proBNP) marker value. All children underwent OCTA with evaluation of the foveal avascular zone (FAZ), whole superficial vessel density (wsVD), foveal superficial vessel density (fsVD), parafoveal superficial vessel density (psVD), whole deep vessel density (wdVD), foveal deep vessel density (fdVD), parafoveal deep vessel density (pdVD), whole thickness (WT), foveal thickness (FT), and parafoveal thickness (PFT). (3) Results: Retinal VD in SP was significantly lower in children with CHF as compared to the controls. The following SP parameters in the study group were statistically significantly lower than these same measurements for the control group. Details, with study group findings quantified first, include wsVD (46.2% vs. 49.83%, p < 0.05), fsVD (18.07% vs. 24.15%, p < 0.05), and psVD (49.24% vs. 52.51%, p < 0.05). The WT (311.03 micrometers (μm) vs. 323.55 μm, p < 0.05), FT (244.57 μm vs. 256.98 μm, p < 0.05), and PFT (320.63 μm vs. 332.02 μm, p < 0.05). No significant differences in DP retinal VD were found between the two groups. No statistically significant differences in the FAZ were found. The fsVD and FT were correlated with biometry and the age of the study participants. There was a correlation between FAZ and FT (p < 0.001). There were no correlations between retinal VD in both plexuses and refractive error, sex, NT-proBNP, and LVEF. (4) Conclusions: In children with CHF in the course of DCM as compared to the control group, significantly decreased retinal VD in SP was observed. The results of our study indicate that measurements of the OCTA may be a useful diagnostic method in children with chronic heart failure, but it is necessary to conduct further studies in larger groups of participants and long-term observation of these patients.

show abstract

“…Given its excellent repeatability and reproducibility, OCTA has been widely used in clinical practice for monitoring microvascular function in hypertension (11), diabetes (12), and so on (13). In our previous study, a significant impairment of retinal microvasculature was found in the OCTA imaging of CHD patients (14). As for the alteration of postoperative retinal microvasculature, although it has been investigated in patients undergoing coronary artery bypass or valve replacement with CPB (15)(16)(17)(18), there is little evidence regarding patients undergoing congenital cardiac surgery.…”

Section: Introductionmentioning

confidence: 88%

Improved Retinal Microcirculation After Cardiac Surgery in Patients With Congenital Heart Disease

Liu

Zhu

Yuan

et al. 2021

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Background: Microcirculatory changes in congenital heart disease (CHD) patients undergoing cardiac surgery are not fully understood. We aimed to investigate the changes of retinal microcirculation in CHD patients after cardiac surgery by optical coherence tomography angiography (OCTA) and explore the association between retinal microcirculation and surgical outcome.Methods: This prospective observational study consisted of 71 CHD patients aged ≥6 years undergoing cardiac surgery including 19 cyanotic CHD (CCHD) and 52 acyanotic CHD (ACHD). Optical coherence tomography angiography (OCTA) was used to measure vessel density (VD) and capillary density (CD) of radial peripapillary capillary (RPC) and peripapillary, VD of superficial capillary plexus (SCP) and deep capillary plexus (DCP), thickness of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) preoperatively and 1 month postoperatively. Transthoracic echocardiography was conducted to measure macrocirculation.Results: In CCHD patients, VD and CD of RPC and peripapillary increased postoperatively (all P < 0.05). In ACHD patients, VD of peripapillary, CD of RPC and peripapillary, and RNFL thickness increased postoperatively (all P < 0.05). VD of SCP and DCP, and GCC thickness did not change significantly in CHD patients after surgery. Lower preoperative retinal microvascular density was associated with longer cardiopulmonary bypass (CPB) time and postoperative length of stay (PLOS). No correlation was found between microcirculatory and macrohemodynamic parameters (all P > 0.05).Conclusions: Improved retinal microcirculation was observed after congenital cardiac surgery and impaired preoperative retinal microvasculature was associated with prolonged CPB time and PLOS, which might provide potential information about the outcome of congenital cardiac surgery.

show abstract

Retinal microvasculature impairment in patients with congenital heart disease investigated by optical coherence tomography angiography

Cited by 16 publications

References 46 publications

Reduced Retinal Microvascular Perfusion in Patients With Stroke Detected by Optical Coherence Tomography Angiography

Reduced Retinal Microvascular Perfusion in Patients With Stroke Detected by Optical Coherence Tomography Angiography

The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

Improved Retinal Microcirculation After Cardiac Surgery in Patients With Congenital Heart Disease

Contact Info

Product

Resources

About