Age-Related Alterations in the Retinal Microvasculature, Microcirculation, and Microstructure

Wei, Yantao; Jiang, Hong; Shi, Yingying; Qu, Dongyi; Gregori, Giovanni; Zheng, Fang; Rundek, Tatjana; Wang, Jianhua

doi:10.1167/iovs.17-21460

Cited by 130 publications

(153 citation statements)

References 46 publications

(76 reference statements)

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“…The retinal structural changes according to age have been evaluated by several studies using OCT [19,25,26]. Yantao et al [19] recruited participants aged from 18 to 82 years and divided them into four groups based on age.…”

Section: Discussionmentioning

confidence: 99%

“…Although there have been studies of VD and FAZ area in adults [13] and children [16] in Asian populations, most studies were on Western populations [12,14,[17][18][19][20] and all used spectral-domain OCTA (SD-OCTA). Swept-source OCT (SS-OCT) provides deeper penetration of the laser beam [21], which allows detailed images and better visualization of the choroid, permitting better calculation of VD and choroidal thickness (CT).…”

Section: Introductionmentioning

confidence: 99%

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Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age

Park

Cho

Hwang

et al. 2020

JCM

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In this cross-sectional study, we examined age-related changes in the retinal vessels of 100 healthy participants, aged from 5 to 80 years, and divided into four groups (G1, under 20 years of age; G2, from 20 to 39 years of age; G3, from 40 to 59 years of age; G4, age 60 years or older). All subjects underwent swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). The vascular density (VD) of the superficial (SCP) and deep capillary plexus (DCP), and choriocapillaris (CCP) were measured using OCTA. The vascular density of each capillary layer, foveal avascular zone (FAZ) area, ganglion cell-inner plexiform layer (GC-IPL) thickness, retinal thickness (RT), and choroidal thickness (CT) were compared between age groups. Most OCT variables were correlated with OCTA variables. The FAZ area; VD of the SCP, DCP, and CCP; GC-IPL thickness; RT; and CT showed significant difference (p < 0.001) between G1 + G2 and G3 + G4, except for central GC-IPL thickness (p = 0.14) and central RT (p = 0.25). Density of the retinal capillary vasculature reduced and FAZ area increased after age 40, which represents the onset of middle age.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age

Park

Cho

Hwang

et al. 2020

JCM

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“…2011; Wei et al. 2017). Additionally, age‐related inflammatory changes are believed to contribute to the pathogenesis of DR (Xu et al.…”

Section: Discussionmentioning

confidence: 99%

“…We hypothesize that subjects with a higher age of onset of T1DM develop DR faster, because the natural ageing process contributes to retinal degeneration, independently of hyperglycaemia. Various microvascular alterations can be observed in the ageing retina, such as increased vessel leakage and declining retinal pigment epithelium cell integrity (Van Kirk et al 2011;Wei et al 2017). Additionally, age-related inflammatory changes are believed to contribute to the pathogenesis of DR (Xu et al 2009).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus

Schreur

Asten

et al. 2018

Acta Ophthalmologica

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PurposeTo investigate risk factors for the development and progression of diabetic retinopathy (DR) and long‐term visual outcomes in Dutch patients with type 1 diabetes mellitus (T1DM).MethodsCumulative incidences were calculated for DR, vision‐threatening DR (VTDR), defined as (pre)proliferative DR and diabetic macular oedema, and best‐corrected visual acuity (BCVA) <0.5 and <0.3 at the most recent eye examination. The following factors were assessed: duration of diabetes, age of onset of T1DM, gender, mean HbA1c, HbA1c variability (defined as coefficient of variation of five separate HbA1c measurements), mean arterial blood pressure, body mass index, albuminuria and lipid profile. We used multivariable Cox regression models to identify factors associated with DR development and progression to VTDR.ResultsWe found 25‐year cumulative incidences of 63% for DR, 21% for VTDR, 2% for BCVA <0.5, and 1% for BCVA <0.3. Mean HbA1c (HR 1.023, p < 0.001), HbA1c variability (HR 1.054, p < 0.001), age of onset of T1DM (HR 1.024, p < 0.001), HDL cholesterol (HR 0.502, p = 0.002) and total cholesterol (HR 1.210, p = 0.029) showed an independent association with faster development of any form of DR. The mean HbA1c (HR 1.023, p < 0.001) and the presence of albuminuria (HR 2.940, p = 0.028) were associated with faster progression to VTDR.ConclusionThese data show relatively low cumulative incidences of DR, VTDR and visual impairment. Higher mean HbA1c, HbA1c variability, age of onset of T1DM and total cholesterol were independently associated with the risk of DR development, and a protective association was found for HDL cholesterol in subjects with T1DM. Mean HbA1c and presence of albuminuria were associated with progression of DR.

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“…The retinal microvasculature can be considered to be more dimensional than a line (1-dimensional), but less than a square (2-dimensional), hence a dimension between 1 and 2 can be attributed to this pattern with a higher number reflecting a more complex branching pattern. The retinal FD is associated with age (Azemin et al, 2012;Che Azemin et al, 2013;Wei et al, 2017), refractive error (Li et al, 2010Azemin et al, 2014;Yang et al, 2016;Al-Sheikh et al, 2017;Tai et al, 2017) and comorbidities (Avakian et al, 2002;Liew et al, 2008;Cheung et al, 2009Cheung et al, , 2011.…”

Section: Introduction Rationalementioning

confidence: 99%

Systematic Review on Fractal Dimension of the Retinal Vasculature in Neurodegeneration and Stroke: Assessment of a Potential Biomarker

et al. 2020

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Introduction: Ocular manifestations in several neurological pathologies accentuate the strong relationship between the eye and the brain. Retinal alterations in particular can serve as surrogates for cerebral changes. Offering a "window to the brain," the transparent eye enables non-invasive imaging of these changes in retinal structure and vasculature. Fractal dimension (FD) reflects the overall complexity of the retinal vasculature. Changes in FD could reflect subtle changes in the cerebral vasculature that correspond to preclinical stages of neurodegenerative diseases. In this review, the potential of this retinal vessel metric to serve as a biomarker in neurodegeneration and stroke will be explored.Methods: A literature search was conducted, following the PRISMA Statement 2009 criteria, in four large bibliographic databases (Pubmed, Embase, Web Of Science and Cochrane Library) up to 12 October 2019. Articles have been included based upon their relevance. Wherever possible, level of evidence (LOE) has been assessed by means of the Oxford Centre for Evidence-based Medicine Level of Evidence classification.Results: Twenty-one studies were included for qualitative synthesis. We performed a narrative synthesis and produced summary tables of findings of included papers because methodological heterogeneity precluded a meta-analysis. A significant association was found between decreased FD and neurodegenerative disease, mainly addressing cognitive impairment (CI) and dementia. In acute, subacute as well as chronic settings, decreased FD seems to be associated with stroke. Differences in FD between subtypes of ischemic stroke remain unclear. Conclusions:This review provides a summary of the scientific literature regarding the association between retinal FD and neurodegenerative disease and stroke. Central pathology is associated with a decreased FD, as a measure of microvascular network complexity. As retinal FD reflects the global integrity of the cerebral microvasculature, it is an attractive parameter to explore. Despite obvious concerns, mainly due to a lack of methodological standardization, retinal FD Lemmens et al.Retinal Fractals: Neurodegeneration and Stroke remains a promising non-invasive and low-cost diagnostic biomarker for neurodegenerative and cerebrovascular disease. Before FD can be implemented in clinic as a diagnostic biomarker, the research community should strive for uniformization and standardization.

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Age-Related Alterations in the Retinal Microvasculature, Microcirculation, and Microstructure

Cited by 130 publications

References 46 publications

Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age

Changes in the Retinal Microvasculature Measured Using Optical Coherence Tomography Angiography According to Age

Risk factors for development and progression of diabetic retinopathy in Dutch patients with type 1 diabetes mellitus

Systematic Review on Fractal Dimension of the Retinal Vasculature in Neurodegeneration and Stroke: Assessment of a Potential Biomarker

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