Comparison between invasive and noninvasive techniques of evaluation of microvascular structural alterations

Ciuceis, Carolina De; Rosei, Claudia Agabiti; Caletti, Stefano; Trapletti, Valentina; Coschignano, Maria Antonietta; Tiberio, Guido A M; Duse, Sarah; Docchio, Franco; Pasinetti, Simone; Zambonardi, F.; Semeraro, Francesco; Porteri, Enzo; Solaini, Leonardo; Sansoni, Giovanna; Pileri, Paolo; Rossini, Claudia; Mittempergher, Francesco; Portolani, Nazario; Ministrini, Silvia; Agabiti‐Rosei, Enrico; Rizzoni, Damiano

doi:10.1097/hjh.0000000000001677

Cited by 38 publications

(46 citation statements)

References 43 publications

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“…However, the need of an expert histopathological unit or special software for image processing and elaboration limits their applicability in clinical practice. 3–24,25 Our study underlines the role of OCT(A), as a device able to identify subclinical microvascular modifications, by means of a non-invasive and reliable retinal vascular network analysis. OCT(A) could potentially become a “multidisciplinary” instrument, not of exclusive ophthalmologist’s use, for the early diagnosis and management of several systemic diseases.…”

Section: Discussionmentioning

confidence: 78%

Optical coherence tomography angiography and arterial hypertension: A role in identifying subclinical microvascular damage?

Donati

Maresca

Cattaneo

et al. 2019

European Journal of Ophthalmology

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Introduction: To evaluate retinal microvasculature modifications by means of optical coherence tomography angiography in human subjects diagnosed with arterial hypertension and to assess potential clinical relevance for early diagnosis. Methods: A cross-sectional study of 30 subjects affected by arterial hypertension compared to a matched cohort of healthy patients was conducted. Patients were evaluated by the Outpatient Clinic for Hypertension and the Retina Center, University of Insubria, Varese, Italy. Patients were divided into three groups: Group 1—healthy subjects, Group 2—patients first diagnosed with hypertension, and Group 3—patients with treated hypertension. Optical coherence tomography angiography was performed applying different analysis protocols for macula and optic disk, using an AngioVue OCTA System on an Optovue device. Morphological data were compared to and correlated with clinical vascular parameters, to evaluate preclinical microvascular damage. Results: A significant reduction in deep vascular layer density (Group 1: 59.2% ± 1.5% standard deviation; Group 2: 59.2% ± 2.2% standard deviation; Group 3: 57.8% ± 2.6% standard deviation; p < 0.05) as well as an enlargement of the deep foveal avascular zone area (Group 1: 0.34 ± 0.09 mm2; Group 2: 0.36 ± 0.07 mm2; Group 3: 0.39 ± 0.1 mm2; p < 0.05) was measured in patients with first diagnosed hypertension and in treated patients compared to healthy subjects. We also observed a significant decrease in mean foveal choroidal thickness in affected patients compared to controls (Group 1: 319.68 ± 61.72 µm standard deviation; Group 2: 251.04 ± 63.1 µm standard deviation; Group 3: 262.65 ± 51.08 µm standard deviation; p < 0.05). Our preliminary data did not show a significant correlation with microalbuminuria levels. Discussion: Retinal vascular density showed pathological modifications between healthy subjects and hypertensive patients. These preliminary findings suggest that optical coherence tomography angiography may identify pathological markers of an early hypertensive damage and help monitor disease progression with potential therapeutic advantages.

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Section: Discussionmentioning

confidence: 78%

Optical coherence tomography angiography and arterial hypertension: A role in identifying subclinical microvascular damage?

Donati

Maresca

Cattaneo

et al. 2019

European Journal of Ophthalmology

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“…The mean wall thickness was calculated from the mean values of the IWT and OWT. The wall-to-lumen ratio (WLR) was calculated by dividing the mean wall thickness of the superior temporal branch of the retinal artery by the lumen diameter (LD); this was applied as a composite measure of the vessel pathology [ 4 , 10 , 20 , 30 , 32 ].…”

Section: Methodsmentioning

confidence: 99%

Optical coherence tomography-based assessment of retinal vascular pathology in cerebral small vessel disease

Abdelhak

Huss

Bruck

et al. 2020

Neurol. Res. Pract.

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Background Cerebral small vessel disease (CSVD) is a disorder of brain vasculature that causes various structural changes in the brain parenchyma, and is associated with various clinical symptoms such as cognitive impairment and gait disorders. Structural changes of brain arterioles cannot be visualized with routine imaging techniques in vivo. However, optical coherence tomography (OCT) is thought to be a “window to the brain”. Thus, retinal vessel parameters may correlate with CSVD characteristic brain lesions and cerebrospinal fluid biomarkers (CSF) of the neuropathological processes in CSVD like endothelial damage, microglial activation and neuroaxonal damage. Methods We applied OCT-based assessment of retinal vessels, magnetic resonance imaging (MRI), and CSF biomarker analysis in a monocentric prospective cohort of 24 patients with sporadic CSVD related stroke and cognitive impairment. MRI lesions were defined according to the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE). Biomarkers were assessed using commercially available ELISA kits. Owing to the unavailability of an age-matched control-group lacking MRI-characteristics of CSVD, we compared the retinal vessel parameters in CSVD patients (73.8 ± 8.5 years) with a younger group of healthy controls (51.0 ± 16.0 years) by using an age- and sex-adjusted multiple linear regression analysis model. Results Among the parameters measured with OCT, the Wall to Lumen Ratio (WLR) but not Mean Wall Thickness (MWT) of the superior branch of the retinal artery correlated significantly with the volume of white matter hyperintensities on MRI (r s = − 0.5) and with CSF-levels of Chitinase 3 like 1 protein (r s = − 0.6), zona occludens 1 protein (r s = − 0.5) and GFAP (r s = − 0.4). MWT and WLR were higher in CSVD than in controls (28.9 μm vs. 23.9 μm, p = 0.001 and 0.32 vs. 0.25, p = 0.001). Conclusions In this exploratory study, WLR correlated with the volume of white matter hyperintensities, and markers of vascular integrity, microglial activation, and neuroaxonal damage in CSVD. Further prospective studies should clarify whether retinal vessel parameters and CSF biomarkers may serve to monitor the natural course and treatment effects in clinical studies on CSVD.

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“…Secondly, the technique used for the retinal microvascular imaging differs from previous techniques used for gluteal small arteries. Although this may account for the different results observed, the pressure myography has been found highly correlated with AOC (40). What is still different is that AOC captures in vivo images of retinal microvasculature, whereas pressure myography assesses arterial anatomy and physiology in standardized conditions that are exempt from physiological local stimuli.…”

Section: :3 380 Clinical Studymentioning

confidence: 86%

IGF-1 is an independent predictor of retinal arterioles remodeling in subjects with uncontrolled acromegaly

Chaigneau

Jublanc

Rosenbaum

et al. 2020

European Journal of Endocrinology

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Context Cardiovascular disease is one of the main causes of morbidity in active acromegaly due to the increased prevalence of risk factors and arterial consequences of increased growth hormone levels. No in vivo study has evaluated the consequences of acromegaly on the retinal microvasculature. Objective The aim of this study was to identify in vivo the presence of morphological alterations of retinal arterioles in subjects with acromegaly. Patients and methods Single-center retrospective study of a cohort of 60 subjects with acromegaly, matched to 60 controls, who were referred for adaptive optics camera (AOC) from September 2014 to December 2016. Of the subjects with acromegaly, 19 had an active disease (AD) and 41 a controlled disease (CD) based on the IGF1 ratio (IGF1r). Retinal arteriolar remodeling was previously assessed using adaptive optics camera (AOC) in order to measure wall-to-lumen ratio (WLR), wall thickness (WT), internal diameter (ID) and wall cross sectional area (WCSA). Results WLR was significantly higher in AD subjects compared to CD subjects and controls (AD: 0.311 ± 0.06, CD: 0.279 ± 0.04, controls: 0.281 ± 0.04, P = 0.031). A significant positive correlation was observed between WLR and IGF-1r (R2 = 0.215, P < 0.001), even after adjustment for gender, age, systolic blood pressure (SBP) and the presence of dopamine agonist treatment (R2 = 0.406, P < 0.001). Retinal arteriolar anatomical indices were comparable between CD and controls. Conclusion Active acromegaly is associated with the presence of small retinal arteriolar remodeling. These results provide new perspectives to better stratify cardiovascular risk and consequently optimize treatment in acromegaly.

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Comparison between invasive and noninvasive techniques of evaluation of microvascular structural alterations

Cited by 38 publications

References 43 publications

Optical coherence tomography angiography and arterial hypertension: A role in identifying subclinical microvascular damage?

Optical coherence tomography angiography and arterial hypertension: A role in identifying subclinical microvascular damage?

Optical coherence tomography-based assessment of retinal vascular pathology in cerebral small vessel disease

IGF-1 is an independent predictor of retinal arterioles remodeling in subjects with uncontrolled acromegaly

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