Are choriocapillaris flow void features robust to diurnal variations? A swept-source optical coherence tomography angiography (OCTA) study

Lin, Emily; Ke, Mengyuan; Tan, Bingyao; Yao, Xinwen; Wong, Damon Wing Kee; Ong, Lirong; Schmetterer, Leopold; Chua, Jacqueline

doi:10.1038/s41598-020-68204-x

Cited by 31 publications

(27 citation statements)

References 43 publications

(79 reference statements)

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“…[61][62][63] The choroidal LA fluctuates in parallel with the diurnal variation in ChT during the day, 64 but the CcFD are not influenced by the diurnal rhythm. 65 Even though the rhythms of AL and ChT in humans could be disturbed by exposure to about 2.00 D myopic or hyperopic defocus for 12 hours during the day, they returned to normal during the second day after removal of the lenses. 51,52 In our present study, the subjects underwent a 20-minute washout period, during which they were exposed to controlled viewing conditions while wearing full optical corrections.…”

Section: Discussionmentioning

confidence: 97%

Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes

Xie

Wang

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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The purpose of this study was to evaluate the interocular differences in choroidal vasculature, choriocapillaris perfusion, and retinal microvascular network, and to explore their associations with interocular asymmetry in axial lengths (ALs) in children with anisomyopia. METHODS.Refractive error, AL, and other biometric parameters were measured in 70 children with anisomyopia. Using optical coherence tomography (OCT) and OCTangiography, we measured the submacular choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), choriocapillaris flow deficit (CcFD), retinal vessel density (VD), and foveal avascular zone (FAZ) area. RESULTS.The mean interocular differences in spherical equivalent refraction and AL were −2.26 ± 0.94 diopters and 0.95 ± 0.46 mm, respectively. Submacular ChT, TCA, LA, SA, and CVI were all significantly lower in the more myopic (longer AL) eyes than in the less myopic (shorter AL) fellow eyes. In eyes with longer ALs, both the CcFD and FAZ areas were significantly greater, whereas the superficial and deep retinal VDs were significantly less. After adjusting for corneal power and intraocular pressure, interocular differences in LA (β = −0.774), SA (β = −0.991), and CcFD (β = 0.040) were significantly associated with interocular asymmetry in AL (all P < 0.05). CONCLUSIONS.In pediatric anisomyopes, eyes with longer ALs tended to have lower choroidal vascularity and choriocapillaris perfusion than the contralateral eyes with shorter ALs. Longitudinal investigations would be useful follow-ups to test for a causal role of choroidal circulation in human myopia.

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Section: Discussionmentioning

confidence: 97%

Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes

Xie

Wang

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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“…The total number of flow deficits were counted, and average sizes computed as the total sizes of flow deficits divide by the total number. Flow deficits metrics showed high inter-session repeatability in normal individuals: in terms of Pearson's R of 0.96 and intraclass correlation coefficients of 0.98 (95% CI, 0.93-0.99) 44 .…”

Section: Measurement Of Choriocapillaris Flow Deficitsmentioning

confidence: 97%

“…The SS-OCTA allows a high-resolution 3-dimensional visualization of perfused microvasculature in a non-invasive manner and characterizes vascular information at the retinal and choriocapillaris layers (Supplementary Figure S3). Participants underwent a 3.0 × 3.0-mm 2 macular centered imaging using the SS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec, Inc., Dublin, USA; Version 1.7) 44 . The OCTA machine provided a signal strength index, ranging from 0 to 10, where only images with a scan quality of 8 and above were accepted.…”

Section: Examination Proceduresmentioning

confidence: 99%

“…Images were exported from the built-in review software (PLEX Elite Review Software, Carl Zeiss Meditec, Inc., Dublin, USA; Version 1.7.1.31492) and MATLAB (The MathWorks, Inc.; Version R2018b) was used to measure CFD automatically using previously published imaging-processing algorithm (Supplementary Figure S4). The density of the flow deficits were calculated as the non-perfused area divided by the area of the image excluding the large vessel 44 . A single flow deficit is defined as an unconnected object in the binarized choriocapillaris image and we used the MATLAB software (The Math-Works, Inc.; Version R2018b) to automatically count the number of flow deficits and measured the size of each flow deficit.…”

Section: Measurement Of Choriocapillaris Flow Deficitsmentioning

confidence: 99%

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Choriocapillaris microvasculature dysfunction in systemic hypertension

Chua

Tan

et al. 2021

Sci Rep

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We examined the choriocapillaris microvasculature using a non-invasive swept-source optical coherence tomography angiography (SS-OCTA) in 41 healthy controls and 71 hypertensive patients and determined possible correlations with BP and renal parameters. BP levels, serum creatinine and urine microalbumin/creatinine ratio (MCR) specimens were collected. The estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. The main outcome was choriocapillaris flow deficits (CFD) metrics (density, size and numbers). The CFD occupied a larger area and were fewer in number in the hypertensive patients with poor BP control (407 ± 10 µm2; 3260 ± 61) compared to the hypertensives with good BP control (369 ± 5 µm2; 3551 ± 41) and healthy controls (365 ± 11 µm2; 3581 ± 84). Higher systolic BP (β = 9.90, 95% CI, 2.86–16.93), lower eGFR (β = − 0.85; 95% CI, − 1.58 to − 0.13) and higher urine MCR (β = 1.53, 95% CI, 0.32–2.78) were associated with larger areas of CFD. Similar significant associations with systolic BP, eGFR and urine MCR were found with number of CFD. These findings highlight the potential role of choriocapillaris imaging using SS-OCTA as an indicator of systemic microvascular abnormalities secondary to hypertensive disease.

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“…Specific optical coherence tomography angiography (OCTA) studies have already shown the extent of the fluctuations occurring in diurnal retinal vessel density (VD) in patients with various types of glaucoma (1)(2)(3)(4)(5)(6)(7)(8)(9). Several studies have indicated a substantial change in retinal VD; some have demonstrated a continuing decline in retinal VD throughout the day (2,4).…”

Section: Introductionmentioning

confidence: 99%

Magnitude of Diurnal Change in Retinal Vessel Density: Comparison Between Exfoliative Glaucoma and Primary Open-Angle Glaucoma

Demirtaş¹

2021

Beyoglu Eye J

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Objectives:The aim of this study was to investigate the magnitude of diurnal fluctuation in the superficial parafoveal vessel density (pfVD) and radial peripapillary capillary-peripapillary vessel density (RPC-ppVD) in exfoliative glaucoma (XFG) patients using optical coherence tomography angiography (OCTA) and to compare the findings with those of primary open-angle glaucoma (POAG) patients with glaucomatous damage of comparable severity. Methods: A total of 50 patients with XFG and 48 with POAG were examined in this retrospective cross-sectional study. The OCTA readings and intraocular pressure (IOP) values were obtained at 9 am, 11 am, 2 pm, and 4 pm on the same day. The maximal change in the IOP and vessel density (VD) values was evaluated to determine the magnitude of diurnal variation. Results: No significant difference was found in the magnitude of the average diurnal superficial-pfVD, RPC-ppVD and IOP change between the XFG and POAG groups. Comparison of the diurnal variation of sub-sector VD revealed that the magnitude of the diurnal variation in the VD of the inferonasal peripapillary and superior parafoveal regions was greater in the XFG group than that of the POAG group (p=0.004 and p=0.021, respectively). Furthermore, the differences persisted after correcting for the confounding factors of IOP, mean deviation (MD), and global retinal nerve fiber layer (RNFL) values. The magnitude of the average superficial-pfVD and the average RPC-ppVD was not correlated with the MD, total ganglion cell complex, global RNFL, or the magnitude of IOP values in either group. Conclusion:The eyes of XFG patients demonstrated more significant diurnal fluctuation in VD (including the superior superficial-pfVD as well as the inferonasal RPC-ppVD) when compared with POAG patients, despite no statistical significance between groups in the IOP variation.

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Are choriocapillaris flow void features robust to diurnal variations? A swept-source optical coherence tomography angiography (OCTA) study

Cited by 31 publications

References 43 publications

Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes

Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes

Choriocapillaris microvasculature dysfunction in systemic hypertension

Magnitude of Diurnal Change in Retinal Vessel Density: Comparison Between Exfoliative Glaucoma and Primary Open-Angle Glaucoma

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