Diurnal variations in flow density measured using optical coherence tomography angiography and the impact of heart rate, mean arterial pressure and intraocular pressure on flow density in primary open‐angle glaucoma patients

Müller, Viktor; Storp, Jens Julian; Kerschke, Laura; Nelis, Pieter; Eter, Nicole; Alnawaiseh, Maged

doi:10.1111/aos.14089

Cited by 30 publications

(22 citation statements)

References 22 publications

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“…This study supports the theory of a steady retinal blood flow due to autoregulation in contrast to the choroidal blood flow with a diurnal pattern. In contrast to our data, Müller et al showed diurnal fluctuation of the macular flow density in the DCP in primary open-angle glaucoma (POAG) patients with a slight increase during the day [27]. The perfusion in SCP did not change significantly, consistent with our findings.…”

Section: Discussionsupporting

confidence: 72%

Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

et al. 2020

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Background: Optical coherence tomography angiography (OCTA) is a non-invasive tool for imaging and quantifying the retinal and choroidal vasculature as well as perfusion state in healthy eyes. Choroidal perfusion is subject to diurnal variation, showing lowest perfusion in the morning and highest in the afternoon. In this index study, OCTA was used to investigate diurnal changes of the retinal perfusion in healthy adult eyes and to identify impacting factors since retinal perfusion is known to be mainly determined by autoregulatory mechanisms. Methods: A prospective study was conducted on healthy volunteers, each of whom underwent repeated measurements of mean arterial pressure (MAP), intraocular pressure (IOP), macular volume (MV), subfoveal choroidal thickness (SFCT), foveal avascular zone (FAZ) and retinal perfusion of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and full retina (FR) slab at 7 a.m. and 4 p.m. Possible influence of MAP or IOP on the retinal perfusion was evaluated. Results: A total of 22 eyes of 22 participants (mean age 55.91 ± 14.84) were analysed. Significant diurnal changes from 7 a.m. to 4 p.m. were observed for MAP (p < 0.001) and SFCT (p = 0.017). The perfusion of SCP, DCP and FR as well as the size of the FAZ and the MV did not show significant fluctuation during the day. No significant correlation between MAP or IOP and retinal perfusion values were detectable. Conclusion: OCTA-based analysis of the retina in healthy adults demonstrated a steady perfusion of both plexus during the day, independently of changes in MAP. These findings support the theory of autoregulatory mechanisms of the retinal blood flow.

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Section: Discussionsupporting

confidence: 72%

Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

et al. 2020

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“…Recent studies have examined the impact of diurnal variations on choriocapillaris flow voids using OCTA in normal subjects 15 , 16 , 19 and patients with idiopathic epiretinal membrane 14 . In a study of 25 normal individuals 15 , SD-OCTA scans were performed at two time points with the AngioVue (Optovue, Fremont, CA, USA).…”

Section: Discussionmentioning

confidence: 99%

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

Lin

Tan

et al. 2020

Sci Rep

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We evaluated the impact of diurnal variation on choroidal and retinal microvasculature and structural measurements using a swept-source optical coherence tomography angiography machine (SS-OCTA; PLEX Elite 9,000, Carl Zeiss Meditec, Inc., Dublin, USA). Fourteen participants who were without ocular diseases underwent SS-OCTA imaging using 3 × 3-mm 2 macular scan pattern on two separate days at five time points. Choriocapillaris flow voids were generated to determine its density (percentage), size (μm) and numbers. Perfusion densities of the large superficial vessels, as well as capillaries on superficial and deep vascular plexuses were generated from retinal angiograms. Subfoveal choroidal and retinal thicknesses were manually measured. Repeated-measures ANOVA was used to investigate the impact of diurnal variation on choroidal and retinal measurements. There was no observable diurnal pattern for any of the flow void features, in terms of the density, size and numbers. There was a significant diurnal pattern observed in the choroidal thickness, where it decreased progressively during the day (P < 0.005). As opposed to sub-foveal choroidal thickness, there does not appear to be significant diurnal variation in choriocapillaris flow voids in normal individuals. This suggests that alterations of choriocapillaris flow deficit seen in pathological eyes will not be confounded by the diurnal fluctuation.

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“…The repeatability of OCT angiography measurements had been well demonstrated in previous studies [19,20]. Factors that could influence the accuracy of OCT angiography measurements included IOP fluctuation [21], refractive media opacity and insufficient signal strength [20,22,23], diurnal variations and blood pressure changes [24]. In our study, we made several efforts to limit confounding factors.…”

Section: Discussionmentioning

confidence: 64%

Effect of silicone oil on peripapillary capillary density in patients with rhegmatogenous retinal detachment

Wang

Chen

et al. 2020

BMC Ophthalmol

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Purpose: To evaluate the effect of silicone oil (SO) on peripapillary blood flow using OCT angiography. Methods: This prospective case series recruited patients with unilateral rhegmatogenous retinal detachment (RRD) who underwent vitrectomy and SO tamponade. Patients were examined before SO removal and at 10 days, 1 month, and 3 months after SO removal on a spectral domain OCT angiography device (RTVue XR Avanti, Optovue Inc., CA, USA) for the measurement of radial peripapillary capillaries (RPC) vessel density (VD) in global field, superior hemifield, and inferior hemifield. Changes in RPC VD following SO removal were compared between affected eyes and contralateral eyes. Results: Twenty-two patients were analyzed. The average duration of SO tamponade was 101.3 days (range, 90 to 119 days). After SO removal, global RPC VD increased by 1.3% (95%CI, 0.3 to 2.3%), compared with a − 0.4% (95%CI, − 1.4 to 0.7%) change in contralateral eyes (P = 0.007). The increase in RPC VD after SO removal mainly occurred in the superior hemifield, which was 1.6% (95%CI, 0.6 to 2.7%). The increase in RPC VD in the inferior hemifield was 1.0% (95%CI, − 0.2 to 2.1%) after SO removal. Conclusions: We detected a mild increase in peripapillary capillary density after SO removal, mainly in the superior hemifield. Our results suggested that SO tamponade could have negative effect on peripapillary blood flow, possibly by capillary compression.

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Diurnal variations in flow density measured using optical coherence tomography angiography and the impact of heart rate, mean arterial pressure and intraocular pressure on flow density in primary open‐angle glaucoma patients

Cited by 30 publications

References 22 publications

Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

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

Effect of silicone oil on peripapillary capillary density in patients with rhegmatogenous retinal detachment

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