Stability of OCT and OCTA in the Intensive Therapy Unit Setting

Courtie, Ella; Kale, Aditya U; Hui, Benjamin T K; Liu, Xiaoxuan; Capewell, Nicholas; Bishop, Jonathan; Whitehouse, Tony; Veenith, Tonny; Logan, Ann; Denniston, Alastair K.O.

doi:10.3390/diagnostics11081516

Cited by 6 publications

(6 citation statements)

References 37 publications

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“…In this pilot study, we investigated the hypothesis that microvascular retinal changes can reflect the microvascular status of coronary circulation by searching for correlations of retinal microvascular indices (namely, capillary vessel density and FAZ size) to morphologic (number of affected coronary vessels) and LVEF parameters in patients with STEMI. Notably, OCTA vascular indices are remarkably repeatable and stable even in the intensive care unit setting, as demonstrated by Courtie et al 16 In particular, decreased SCP vessel density has been associated with higher concentrations of osteoprotegerin and angiopoietin-2 in patients hospitalized for acute coronary syndrome versus controls. 17 …”

Section: Discussionmentioning

confidence: 71%

Correlation Between Coronary and Retinal Microangiopathy in Patients With STEMI

Sideri

Kanakis

Katsimpris

et al. 2023

Trans. Vis. Sci. Tech.

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Purpose To investigate the morphological and functional correlation between microvascular retinal changes in optical coherence tomography angiography (OCTA) and the microvascular coronary circulation in patients with ST elevation myocardial infarction (STEMI) coronary heart disease (CHD). Methods A total of 330 eyes from 165 participants (88 cases and 77 controls) were enrolled and imaged. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vascular density was measured in the central (1 mm) and perifoveal (1–3 mm) areas and in the superficial foveal avascular zone (FAZ) and choriocapillaris (3 mm). These parameters were then correlated to the left ventricular ejection fraction (LVEF), and the number of affected coronary arteries. Results Decreased vessel densities in the SCP and DCP and choriocapillaris were positively correlated to the LVEF values ( P = 0.006, P = 0.026, and P = 0.002, respectively). No statistically significant correlation between the SCP and DCP central area or FAZ area was found. Regarding the number of affected vessels, significant negative correlations were revealed for the SCP and DCP central vessel densities ( P < 0.001 and P < 0.001, respectively) and the SCP perifoveal vascular density ( P = 0.009). Conclusions OCTA vascular indices are significantly correlated with morphological and functional parameters in patients with STEMI CHD. SCP vascular density especially seems to be a promising biomarker for the extent of both macrovascular damage (number of affected coronary arteries) and microvascular damage, as mirrored in the decreased LVEF at admission. Translational Relevance OCTA vascular indices offer a valuable insight into the microvascular status of coronary circulation.

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Section: Discussionmentioning

confidence: 71%

Correlation Between Coronary and Retinal Microangiopathy in Patients With STEMI

Sideri

Kanakis

Katsimpris

et al. 2023

Trans. Vis. Sci. Tech.

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“…In our study, we did not find an association between OCTA measures and resting arterial blood flow, possibly suggesting retinal/central perfusion stability. In a small study (35 eyes from 18 patients) of pre- and post-operative major non-neurological surgery requiring planned intensive therapy unit (ITU) admission, 46 retinal blood flow was stable and the authors conclude that the stability of retinal blood flow measures suggests the potential for OCTA to provide clinically useful measures in ITU patients. OCTA could be used as a potential biomarker of central perfusion in SVD but more data is needed.…”

Section: Discussionmentioning

confidence: 99%

Retinal capillary microvessel morphology changes are associated with vascular damage and dysfunction in cerebral small vessel disease

Wiseman

Zhang

Gray

et al. 2022

J Cereb Blood Flow Metab

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Cerebral small vessel disease (SVD) is a cause of stroke and dementia. Retinal capillary microvessels revealed by optical coherence tomography angiography (OCTA) are developmentally related to brain microvessels. We quantified retinal vessel density (VD) and branching complexity, investigating relationships with SVD lesions, white matter integrity on diffusion tensor imaging (DTI) and cerebrovascular reactivity (CVR) to CO2 in patients with minor stroke. We enrolled 123 patients (mean age 68.1 ± SD 9.9 years), 115 contributed retinal data. Right (R) and left (L) eyes are reported. After adjusting for age, eye disease, diabetes, blood pressure and image quality, lower VD remained associated with higher mean diffusivity (MD) (standardized β; R −0.16 [95%CI −0.32 to −0.01]) and lower CVR (L 0.17 [0.03 to 0.31] and R 0.19 [0.02 to 0.36]) in normal appearing white matter (NAWM). Sparser branching remained associated with sub-visible white matter damage shown by higher MD (R −0.24 [−0.08 to −0.40]), lower fractional anisotropy (FA) (L 0.17 [0.01 to 0.33]), and lower CVR (R 0.20 [0.02 to 0.38]) in NAWM. OCTA-derived metrics provide evidence of microvessel abnormalities that may underpin SVD lesions in the brain.

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“…To analyze the OCTA scans in MatLab, we used the approach and custom code reported by Zahid et al, 14 assessing vascular morphology by measuring fractal dimension (FD) and skeletal fractal dimension (SFD), and vessel density assessed by vessel density (VD) and skeletal VD (SVD), all derived from binarized images and expressed as arbitrary units, as previously reported. 13 , 14 …”

Section: Methodsmentioning

confidence: 99%

“…Although studies have looked at agreement in measures of macular perfusion using OCTA between devices 11 and at methods to calculate macular vessel density, 12 the extent of agreement between different OCTA analysis methods and metrics is not previously reported, impairing comparison of OCTA studies using different measures. We aimed to investigate the correlation and agreement of analysis methods derived from four different approaches using the following third-party and manufacturer's software applied to Heidelberg Spectralis OCTA scans: (1) MatLab (M; MATLAB R2021a; MathWorks, Natick, MA, USA) 13 – 16 ; (2) Heidelberg SP-X1902 (H; Heidelberg Engineering, Heidelberg, Germany); (3) ImageJ Fiji (IJ; National Institutes of Health, Bethesda MD, USA) 17 – 20 ; and (4) Fractalyse (F; ThéMA, Besançon, France) 21 – 25 , to determine their comparability and preferred methods to use going forward.…”

Section: Introductionmentioning

confidence: 99%

Reliability of Optical Coherence Tomography Angiography Retinal Blood Flow Analyses

Courtie

Gilani

Capewell

et al. 2023

Trans. Vis. Sci. Tech.

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Purpose Investigate the association between the optical coherence tomography angiography (OCTA) metrics derived from different analysis programs to understand the comparability of studies using these different approaches. Methods Secondary analysis of a prospective observational study (March 2018–September 2021). Forty-four right eyes and 42 left eyes from 44 patients were included. Patients were either undergoing upper gastrointestinal surgery with a critical care stay planned or were already in the critical care unit with sepsis. OCTA scans were obtained in an ophthalmology department or critical care setting. Fourteen OCTA metrics were compared within and between the programs, and agreement was measured by Pearson's R coefficient and intraclass correlation coefficient. Results Correlation was highest between all Heidelberg metrics and Fractalyse (all >0.84), and lowest between Matlab skeletonized or foveal avascular zone metrics and all other measures (e.g., skeletal fractal dimension and vessel density at −0.02). Agreement between eyes was moderate to excellent in all metrics (0.60–0.90). Conclusions The significant variability between metrics and programs used for OCTA analysis demonstrates that they are not interchangeable and supports a recommendation for perfusion density metrics to be reported as standard. Translational Relevance Agreement between different OCTA analyses is variable and not interchangeable. The high agreement between non-skeletonized vessel density metrics suggests that these should be routinely reported.

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Stability of OCT and OCTA in the Intensive Therapy Unit Setting

Cited by 6 publications

References 37 publications

Correlation Between Coronary and Retinal Microangiopathy in Patients With STEMI

Correlation Between Coronary and Retinal Microangiopathy in Patients With STEMI

Retinal capillary microvessel morphology changes are associated with vascular damage and dysfunction in cerebral small vessel disease

Reliability of Optical Coherence Tomography Angiography Retinal Blood Flow Analyses

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