Retinal vessel oxygen saturation is affected in uveitis associated with Vogt-Koyanagi-Harada disease

El‐Asrar, Ahmed M. Abu; AlBloushi, Abdulrahman F; Gikandi, Priscilla W; Hardarson, Sveinn Hákon; Stefánsson, Einar

doi:10.1136/bjophthalmol-2018-313719

Cited by 8 publications

(18 citation statements)

References 25 publications

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“…These reversible retinal oximetry changes may provide a deeper understanding of the underlying physiological changes and can be used to monitor patients with lipemia retinalis. The reversibility of retinal oxygen saturation with treatment has also been reported in patients with Vogt-Koyanagi-Harada disease (VKH) [ 24 , 25 ]. Results of oxygen saturation in untreated lipemia retinalis may be affected by some parameters.…”

Section: Discussionmentioning

confidence: 99%

Alterations in ocular microcirculation and oxygen metabolism in patients with lipemia retinalis

Alsarhani

Adel²,

Alamri³

et al. 2022

BMC Ophthalmol

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Purpose The study aims to assess the alterations in retinal oxygen saturation and retinal and choroidal blood flow in lipemia retinalis. Methods This was a cross-sectional study on 10 eyes (5 patients) with history of lipemia retinalis. The study comprised 10 eyes with documented history of lipemia retinalis and 10 participants as healthy controls. Patients with a confirmed history of lipemia retinalis were grouped into two cohorts based on their most recent fundus examination: untreated lipemia retinalis (abnormal fundus) and resolved lipemia retinalis (normal fundus). Both retinal arteriolar and venular oxygen saturation were measured using the non-invasive spectrophotometric retinal oximeter (Oxymap T1). The mean blur rate (MBR) of the optic nerve and choroidal blood flow were analyzed using a laser speckle flowgraph (LSFG). Results Patients with untreated lipemia retinalis had a significantly higher retinal arteriolar and venular oxygen saturation than that of the other two groups (p < 0.001). Moreover, patients with untreated lipemia retinalis had significantly smaller retinal arteriolar and venular diameters (p < 0.001). On LSFG, there was a significant difference in the overall MBR (p = 0.007) and vessel MBR of the optic nerve between the groups (p = 0.011). The patients with history of lipemia retinalis (untreated and resolved) exhibited a high overall MBR and vessel MBR of the optic nerve than that of the control group. There was a significant elevation of the optic nerve (p = 0.002) and choroidal blowout score (p < 0.001), while the resistivity index of the optic nerve (p = 0.001) and choroids (p = 0.002) was significantly lower in patients with resolved and untreated lipemia retinalis. Conclusions There was a significant alteration in retinal oximetry, in untreated lipemia retinalis, and in retinal blood flow, in both the resolved and untreated groups. The increase in retinal blood flow and oxygen saturation may elucidate the preservation of visual acuity and function despite the fundus changes observed in lipemia retinalis.

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Section: Discussionmentioning

confidence: 99%

Alterations in ocular microcirculation and oxygen metabolism in patients with lipemia retinalis

Alsarhani

Adel²,

Alamri³

et al. 2022

BMC Ophthalmol

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“…Increased blood flow will raise the oxygen saturation in retinal arterioles and venules because less oxygen will be lost from per unit volume of blood (Hardarson et al 2009). In a previous study, we reported the mean oxygen saturation values in retinal arterioles and venules as well as the mean diameters of retinal arterioles and venules in healthy controls (Abu El‐Asrar et al 2019). In the present study, these values were comparable to that of healthy controls after immunosuppressive therapy at final follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, we demonstrated that the retinal oxygen metabolism is altered in uveitis associated with VKH disease and that it might serve as a potential biomarker of the outcome (Abu El‐Asrar et al 2019). However, to the best of our knowledge, there has been no previous study to investigate the effect of immunosuppressive therapy on retinal vascular oxygen saturation and calibres in initial‐onset acute uveitis associated with VKH disease.…”

Section: Introductionmentioning

confidence: 96%

Effect of immunosuppressive therapy on oxygen saturation and diameter of retinal vessels in initial onset acute uveitis associated with Vogt‐Koyanagi‐Harada disease

El‐Asrar

Alotaibi

Gikandi

et al. 2020

Acta Ophthalmologica

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Purpose To demonstrate changes in oxygen saturation and calibre of retinal vessels in initial‐onset acute uveitis associated with Vogt–Koyanagi–Harada (VKH) disease at baseline and during immunosuppressive therapy. Methods In this prospective study, 22 patients (44 eyes) were studied. Retinal oximetry measurements were performed using the noninvasive spectrophotometric retinal oximeter (Oxymap T1) at baseline and at 1–3 months, 4–6 months, 5–7 months and more than 9 months after treatment. Results At baseline, mean logarithm of the minimum angle of resolution (logMAR) best‐corrected visual acuity (BCVA) was 1.12 ± 0.78 (Snellen equivalent, 20/265). Arteriolar and venular oxygen saturations were 108 ± 7% and 70 ± 9%, respectively and calibres of arterioles and venules were 12.1 ± 1.1 pixels and 16.9 ± 1.4 pixels, respectively. At 4–6 months of follow‐up, logMAR BCVA was almost maximum (0.08 ± 0.1, Snellen equivalent 20/24; p < 0.001) and thereafter remained almost unchanged. After immunosuppressive therapy, arteriolar and venular oxygen saturation values continued to decrease up to >9 months of follow‐up (92 ± 7% and 56 ± 10%, respectively; p < 0.001 for both arterioles and venules). Similarly, arteriolar and venular calibres continued to decrease up to >9 months of follow‐up to 11.4 ± 0.9 pixels (p = 0.006) and 15.6 ± 1.3 pixels (p = 0.001), respectively. Conclusions Eyes with initial‐onset acute uveitis associated with VKH disease have increased oxygen saturation and calibres of retinal vessels at baseline. Immunosuppressive therapy normalizes these changes and in a similar pattern improves BCVA.

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“…2016; Abu El‐Asrar et al . 2012, 2019, 2021a, 2021b). A total of 20 patients (40 eyes) with initial‐onset acute uveitis associated with VKH disease were included in the study.…”

Section: Methodsmentioning

confidence: 99%

“…In previous studies, we demonstrated the presence of abnormal retinal oxygen metabolism and calibre of retinal vessels in patients with initial‐onset acute uveitis associated with VKH disease and that immunosuppressive therapy normalized these changes (Abu El‐Asrar et al . 2019, 2021b).…”

Section: Introductionmentioning

confidence: 99%

Changes in ocular blood flow and retinal oxygen metabolism during immunosuppressive therapy for initial‐onset acute uveitis associated with Vogt–Koyanagi–Harada disease

El‐Asrar

AlBloushi

Gikandi

et al. 2022

Acta Ophthalmologica

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Purpose: The aim of this study was to investigate the correlations between visual acuity, blood flow velocity in the choroid and optic nerve head (ONH) and oxygen saturation and calibre of retinal vessels during immunosuppressive therapy in patients with initial-onset acute uveitis associated with Vogt-Koyanagi-Harada (VKH) disease. Methods: In this prospective study, 20 patients were studied. Laser speckle flowgraphy (LSFG) and retinal oximetry measurements were performed at baseline and at 4, 8 and 12 weeks after treatment. Results: After immunosuppressive therapy, best-corrected visual acuity (BCVA) improved significantly at each post-treatment time-point compared with baseline value. Mean blur rate (MBR), representing blood flow velocity, in the choroid and ONH (overall and vessel areas) significantly increased. On the contrary, oxygen saturation of retinal arterioles and venules and calibre of retinal venules significantly decreased. There were significant negative correlations between ONH MBR vessel and arteriovenous oxygen saturation difference at baseline and at 4 weeks after treatment and between MBR tissue of the ONH and arteriovenous oxygen saturation difference at week 12 after treatment. Conclusions: Immunosuppressive therapy in patients with initial-onset acute uveitis associated with VKH disease is associated with improved blood flow velocity in choroid and ONH and normalization of retinal oxygen metabolism and calibre of retinal venules. These correspond with improved visual acuity. These findings help explain the pathophysiology of VKH disease and its treatment and may provide biomarkers for choroiditis activity and response to treatment.

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Retinal vessel oxygen saturation is affected in uveitis associated with Vogt-Koyanagi-Harada disease

Cited by 8 publications

References 25 publications

Alterations in ocular microcirculation and oxygen metabolism in patients with lipemia retinalis

Alterations in ocular microcirculation and oxygen metabolism in patients with lipemia retinalis

Effect of immunosuppressive therapy on oxygen saturation and diameter of retinal vessels in initial onset acute uveitis associated with Vogt‐Koyanagi‐Harada disease

Changes in ocular blood flow and retinal oxygen metabolism during immunosuppressive therapy for initial‐onset acute uveitis associated with Vogt–Koyanagi–Harada disease

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