Characterization by Fractal Dimension Analysis of the Retinal Capillary Network in Parkinson Disease

Shi, Chaoji; Chen, Yihong; Kwapong, William Robert; Tong, Qiaowen; Wu, Senxiang; Zhou, Yuheng; Miao, Huikai; Shen, Meixiao; Ye, Hua

doi:10.1097/iae.0000000000002641

Cited by 50 publications

(59 citation statements)

References 30 publications

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“…Research by Shi et al, unique in its position addressing retinal microvascular changes in PD and one of two studies using OCT-A, showed that FD of the superficial vascular plexus was decreased in all analyzed regions and that FD of the deep vascular plexus was decreased in all but two ROIs. Of note, this was the only study able to confirm a significant correlation with disease duration (Shi et al, 2019). Table 3 summarizes the findings on fractal dimension analysis of the retinal vasculature in stroke patients.…”

Section: Outcomes Of Fractal Analysis In Studies On Neurodegenerativementioning

confidence: 79%

“…Patient characteristics of included studies are reported in Table 1. Subjects included in the central neurodegeneration section of this review show heterogeneity in mean age ranging from 59 (Shi et al, 2019) up to 81 (Cabrera DeBuc et al, 2018) years. In the section dedicated to studies focusing on stroke patients, the heterogeneity in mean age is even higher, from 44 (Cavallari et al, 2011) up to 74 (Kawasaki et al, 2011.…”

Section: Study Characteristicsmentioning

confidence: 99%

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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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Section: Outcomes Of Fractal Analysis In Studies On Neurodegenerativementioning

confidence: 79%

Section: Study Characteristicsmentioning

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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“…In addition to neurodegeneration, the vascular impairment has been identified as a possible key factor to the occurrence and progression of PD [ 83 ]. Recently, retinal microvessel status has been evaluated in patients with PD using OCTA [ 84 , 85 ]. Patients with early stage PD showed a reduced perfusion density of SCP in all the quadrants evaluated individually and in the total annular zone, defined as an area of 2.5 mm diameter centered on the fovea excluding the FAZ [ 84 , 85 ].…”

Section: Parkinson’s Diseasementioning

confidence: 99%

“…Recently, retinal microvessel status has been evaluated in patients with PD using OCTA [ 84 , 85 ]. Patients with early stage PD showed a reduced perfusion density of SCP in all the quadrants evaluated individually and in the total annular zone, defined as an area of 2.5 mm diameter centered on the fovea excluding the FAZ [ 84 , 85 ]. Given previous studies on animal models of PD reporting the accumulation of α-synuclein at the level of the wall of arteries, authors hypothesized that the same pathogenetic mechanism could explain the decreased perfusion density in SCP in PD patients [ 83 ].…”

Section: Parkinson’s Diseasementioning

confidence: 99%

Optical Coherence Tomography Angiography in Neurodegenerative Disorders

Pellegrini

Vagge

Desideri

et al. 2020

JCM

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Retinal microcirculation shares similar features with cerebral small blood vessels. Thus, the retina may be considered an accessible ‘window’ to detect the microvascular damage occurring in the setting of neurodegenerative disorders. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality providing depth resolved images of blood flow in the retina, choroid, and optic nerve. In this review, we summarize the current literature on the application of OCT-A in glaucoma and central nervous system conditions such as Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Future directions aiming at evaluating whether OCT-A can be an additional biomarker for the early diagnosis and monitoring of neurodegenerative disorders are also discussed.

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“…OCTA provided a unique and non-invasive technique for the evaluation of blood flow and vascular density and has been applied to the prediction of disease beyond the retinal vascular disease, such as Alzheimer’s disease and Parkinson’s disease [ 15 , 16 ]. The imaging study of intraocular tumors using OCTA was a new field.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography angiography characteristics of optic disc melanocytoma

Zhou

Wei

2020

BMC Ophthalmol

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Background Optic disc melanocytoma (ODMC) was a benign pigmented intraocular tumor with the rare potential malignant transformation. This study was designed to evaluate tumor vasculature with optical coherence tomography angiography (OCTA) in ODMC. Methods Eyes of healthy individuals in a control group and of patients with ODMC were imaged by OCTA systems operating at 840 nm wavelengths and examined. The main outcome measures were OCTA images, qualitative evaluation of optic disc and tumor vasculature, quantitative vascular density (VD) and perfusion density (PD). Results One eye of ten normal volunteers and ten patients with ODMC were imaged. Eyes affected by ODMC as compared to the eyes of the control group (all P < 0.05). The healthy optic disc had radially-oriented vessels within the retina on OCTA. Optic disc melanocytoma was characterized by globular, demonstrated tortuous blood vessels, uneven thickness, and relatively disorganized intratumoral vasculature. The VD and PD within ODMC were significantly higher (12.360% ± 4.175, 0.316% ± 0.119%, P < 0.0001) than in normal optic discs (4.160% ± 2.290, 0.102% ± 0.0, 56%, P < 0.0001). No significant differences were established of the VD and PD in each single measurement zone (P > 0.05) between the ODMC and the control eyes. At 840 nm, OCTA could provide sufficient visualization of the tumor vasculature and better penetration through thicker tumors. The full thickness was visualized even in thicker tumors and highly pigmented lesions (> 2 mm). Interpretable OCTA images were obtained in 96% of the participants in whom imaging was attempted. Conclusions OCTA may provide a noninvasive, safe, and efficient technique for evaluating a variety of neoplasms including the growth and vascularity in ODMC. OCTA could facilitate the evaluation of the vascular abnormalities of tumors and the effect of melanin on the penetration of the OCTA beam was not significant.

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Characterization by Fractal Dimension Analysis of the Retinal Capillary Network in Parkinson Disease

Cited by 50 publications

References 30 publications

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

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

Optical Coherence Tomography Angiography in Neurodegenerative Disorders

Optical coherence tomography angiography characteristics of optic disc melanocytoma

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