Agreement among three examiners of colour Doppler imaging retrobulbar blood flow velocity measurements

Founti, Panayiota; Harris, Alon; Papadopoulou, Domniki N.; Emmanouilidis, Petros; Siesky, Brent; Kilintzis, Vassilis; Anastasopoulos, Eleftherios; Salonikiou, Angeliki; Topouzis, Fotis

doi:10.1111/j.1755-3768.2011.02236.x

Cited by 18 publications

(13 citation statements)

References 22 publications

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“…However, highly reproducible results for PSV and EDV in OA and CRA have been reported in a recent study where a rigorous protocol was established, an intensive training was performed by an expert and CDI images were analysed by a single masked grader [17].…”

Section: Discussionmentioning

confidence: 99%

Inter-device reproducibility of retrobulbar blood flow velocity measurements in healthy subjects using color Doppler imaging

C.¹,

Cutolo

Dellafiore

et al. 2016

J Ultrasound

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Purpose To evaluate the inter-device reproducibility of retrobulbar blood flow measurements obtained by two commercially available CDI (color Doppler imaging) devices. Methods The right eyes of 10 healthy volunteers were investigated. Four examiners, namely two ophthalmologists and two radiologists, performed CDI examination of the ophthalmic artery, central retinal artery and temporal short posterior ciliary arteries using both CDI devices: ESAOTE MYLAB TM and SIEMENS ANTARES STEL-LAR PLUS TM . The peak systolic velocity (PSV), the enddiastolic velocity (EDV) and the resulting resistivity index (RI) were averaged for 3 cardiac cycles. To evaluate the reproducibility between both device measurements, the Lin's concordance correlation coefficient (CCC) was used. CCC can be expressed as the product of Pearson's r (the measure of precision) and C_b (the measure of accuracy). Results Results show that the inter-device reproducibility for CDI measurements is not acceptable since a poor degree of overall concordance (0.15\CCC\0.37) was obtained: accuracy was high (C_b [ 0.71) but overall precision low (0.18\Pearson's r\0.47). Ophthalmologists and radiologists obtained similar results. Conclusions To evaluate the causal role of blood flow abnormalities in glaucoma, CDI analysis using different devices seems unreliable. CDI inter-device reproducibility seems unrelated to medical speciality of the examiners. However, to improve present results, the use of similar probes and standardized CDI instrument settings as well as a CDI images analysis by a single grader, might possibly improve the inter-device reproducibility when testing the retrobulbar blood flow velocity.Keywords Blood flow velocity Á Doppler ultrasound imaging Á Glaucoma Á Healthy volunteers Á Reproducibility of results AbstractScopo Valutare la riproducibilità delle misurazioni delle velocità di flusso ematico nei vasi retrobulbari di volontari sani: le misurazioni sono state ottenute con due diverse strumentazioni ecografiche commercialmente disponibili. Materiali e Metodi Quattro operatori, due radiologi e due oculisti, hanno misurato le velocità di flusso nell'arteria oftalmica (AO), nell'arteria centrale della retina (ACR) e nelle arterie ciliari posteriori brevi (ACPB) in 10 occhi di volontari sani utilizzando due ecografi: ESAOTE MYLAB TM and SIEMENS ANTARES STELLAR PLUS TM . Sono state calcolate le medie di 3 cicli cardiaci dei parametri di flusso PSV (velocità di picco sistolico), EDV (velocità di fine diastole) e IR (indice di resistività). Per valutare la riproducibilità delle misure effettuate con le due strumentazioni è stato calcolato il coefficiente di correlazione di Lin (CCC). Il CCC può essere espresso come il prodotto del coefficiente di Pearson's r (misura della precisione) e C_b (misura dell'accuratezza). Risultati I risultati mostrano che la riproducibilità delle misurazioni tra due ecografi non è accettabile dal momento che è stato ottenuto uno scarso grado di concordanza (0.15\CCC\0.37): il grado di accuratezza è alto (C_b [ 0....

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Section: Discussionmentioning

confidence: 99%

Inter-device reproducibility of retrobulbar blood flow velocity measurements in healthy subjects using color Doppler imaging

C.¹,

Cutolo

Dellafiore

et al. 2016

J Ultrasound

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“…However, due to limitations known in this technology, vessel diameter cannot be measured by CDI and thus flow cannot be accurately measured. Nevertheless, CDI is a widely validated technique (Stalmans et al 2009) (Founti et al 2011) that may provide further information about autoregulation in these vessels, which is reportedly defective in glaucoma patients (Grieshaber et al 2007) (Nicolela 2008). Gosling index or pulsatility index (PI) and mean flow velocities (MFV) have been used for decades now to study cerebral arteries vasoreactivity (Werner et al 1990) (Bellapart & Fraser 2009).…”

Section: Introductionmentioning

confidence: 99%

Disturbed correlation between arterial resistance and pulsatility in glaucoma patients

Pinto

Vandewalle

Stalmans

2012

Acta Ophthalmologica

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ABSTRACT.Purpose: (i) To investigate whether pulsatility index (PI) and mean flow velocities (MFV) are altered in glaucoma patients. (ii) To evaluate the significance of PI in retrobulbar autoregulation capacity. Methods:Patients with primary open-angle glaucoma (POAG; n = 49), normal tension glaucoma (NTG; n = 62) and healthy controls (n = 48) underwent colour Doppler imaging measurements of the retrobulbar vasculature. Kruskal-Wallis test was used to compare variables between the three diagnostic groups. Restricted cubic splines were used to determine nonlinearities between the resistive index (RI) and PI correlations. Results: Mean flow velocities (MFV) were lower in both short posterior ciliary arteries (SCPA) and central retinal arteries (CRA) from the two glaucoma groups (p < 0.04 versus healthy controls). No differences were detected in RI or PI in any arteries of the three diagnostic groups (p > 0.08). In healthy individuals, correlations between RI and PI were linear in all arteries. In both POAG and NTG patients, CRA presented a nonlinear curve with a cutpoint at RI 0.77 (p < 0.001) and 0.61 (p = 0.03), respectively, above which the slope increased nearly five-and tenfold (POAG: 1.96 to 10.06; NTG: )0.46-4.06), respectively. A nonlinear correlation in the ophthalmic artery was only observed in NTG patients, with a cutpoint at RI 0.82 (p < 0.001), above which the slope increased from 3.47 to 14.03. Conclusions: Glaucoma patients do not present the linear relationships between RI and PI observed in healthy individuals. Their nonlinear relations may be indicative of an altered autoregulation and suggest a possible threshold RI could be determined above which autoregulatory disturbances become more relevant.

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“…29 Therefore, we do not believe that the use of three different sonographers in the present study had a significant effect on the assessment of variability. We found no significant difference in the between-visit CoV according to whether the participant’s OBF in the CRA was assessed by the same sonographer at both visits or different sonographers at each visit for PSV ( p = 0.70) and EDV ( p = 0.41).…”

Section: Discussionmentioning

confidence: 66%

Reduced Central Retinal Artery Blood Flow Is Related to Impaired Central Visual Function in Retinitis Pigmentosa Patients

Kayser

Vargas²,

Mendelsohn³

et al. 2017

Current Eye Research

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Purpose We evaluated the test-retest repeatability of blood flow velocities in the retrobulbar central retinal artery (CRA) and explored whether reduced blood flow is related to the degree of visual function loss in retinitis pigmentosa (RP) patients with wide range of disease severity. Materials and Methods We measured CRA peak systolic velocity (PSV) and end diastolic velocity (EDV) to calculate mean flow velocity (MFV) in 18 RP patients using color Doppler imaging with spectral flow Doppler (GE Logiq7 ultrasound) twice in each eye at each of two visits within a month. At each of these two visits, we measured ETDRS visual acuity (VA), quick Contrast Sensitivity Function (qCSF), Goldmann visual fields (GVF), 10–2 Humphrey visual fields (HVF), and dark-adaptation at 5° from fixation with the AdaptDx; multifocal electroretinography (mfERG) was obtained at a single visit. Results Mean coefficients of variation for PSV, EDV and MFV were 16.1–19.2% for within-visit measurements and 20.1–22.4% for between-visit measures. Across patients, greater visual function loss assessed with VA (p = 0.04), extinguished versus measurable amplitude in ring 1 for mfERG (p = 0.001), and cone-only versus rod function with the AdaptDx (p = 0.002) were statistically significantly correlated with reduced MFV in the CRA when included a multilevel multivariate regression model along with the qCSF and HVF results, which all together accounted for 47% of the total variance in MFV. GVF log retinal areas (V4e and III4e; p = 0.30 and p = 0.95, respectively) and measurable far peripheral vision during GVF testing (p = 0.66) were not significantly related to MFV. Conclusions MFV in the CRA decreased with impaired central vision due to loss of both rod and cone function, had good test-retest repeatability, and may serve as a biomarker outcome to determine the potential physiological basis for improvements in RP clinical trials of therapies with indirect effects on blood flow to the retina.

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Agreement among three examiners of colour Doppler imaging retrobulbar blood flow velocity measurements

Cited by 18 publications

References 22 publications

Inter-device reproducibility of retrobulbar blood flow velocity measurements in healthy subjects using color Doppler imaging

Inter-device reproducibility of retrobulbar blood flow velocity measurements in healthy subjects using color Doppler imaging

Disturbed correlation between arterial resistance and pulsatility in glaucoma patients

Reduced Central Retinal Artery Blood Flow Is Related to Impaired Central Visual Function in Retinitis Pigmentosa Patients

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