Evaluating diurnal changes in choroidal sublayer perfusion using optical coherence tomography angiography

Siegfried, Fynn; Rommel, Felix; Rothe, Matthias; Brinkmann, Max; Sochurek, Jan A M; Freitag, Josephine Christin; Grisanti, Salvatore; Ranjbar, Mahdy

doi:10.1111/aos.14140

Cited by 32 publications

(43 citation statements)

References 46 publications

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“…These results differ from findings of diurnal variation in choroidal perfusion. The healthy choroid, in particular Sattler's and Haller's layer, is known to be subject to diurnal variation [8,17,18]. Our recent OCTA-based study demonstrated a quadratic relation of the perfusion in both sublayers to time of the day, with the lowest perfusion state at 7 a.m. and the highest at 4 p.m. [8].…”

Section: Discussionmentioning

confidence: 70%

“…Diurnal variations have previously been shown for intraocular pressure (IOP), axial length (AL) and subfoveal choroidal thickness (SFCT) [6,7]. Recently, we demonstrated significant diurnal patterns in choroidal sublayer perfusion in healthy adults and eyes with epiretinal membrane in OCTA-based studies [8,9]. Analyzation of choroidal sublayer perfusion in healthy adults showed significant diurnal variation in Sattler's and Haller's layer perfusion.…”

Section: Open Accessmentioning

confidence: 66%

“…Each en face image was exported into ImageJ (NIH, Version 1.48b, Bethesda, USA) and binarized by the Otsu method, which is an automatic threshold selection from grey-level histograms, to determine the percentage of white and black pixels [15]. Retinal perfusion was calculated by scoring the percentage of white pixels in relation to number of total pixels, according to published protocols [8,9,16].…”

Section: Methodsmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 70%

Section: Open Accessmentioning

confidence: 66%

Section: Methodsmentioning

confidence: 99%

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Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

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“…Additionally, many children did not follow instructions correctly and some examinations were considered as statistically non reliable. Another limitation of our work was that we could not consider diurnal variations of CC perfusion [32]. Tan et al studied how circadian rhythms affect subfoveal choroidal thickness and they found that the highest values were in the morning at 9:00 a.m. and the lowest values were in the evening at 5:00 p.m. [33].…”

Section: Discussionmentioning

confidence: 94%

Determination of Referential Rates for Optical Coherence Tomography and Optical Coherence Tomography Angiography Flow Deficits in the Macular Choriocapillaris in Ophthalmologically Healthy Children

et al. 2020

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Background and Objectives: Despite the growing number of new research publications, normative references for children’s optical coherence tomography (OCT) parameters are still not completed. We chose to explore this topic because of the lack of normative parameters that is due to an improvement in different technologies and instruments. Our aim was to determine referential rates of retinal nerve fiber layer (RNFL) thickness and flow deficits (FD%) in the macular choriocapillaris (CC) in normal eyes of ophthalmologically healthy children. Materials and Methods: Ophthalmologically healthy 8- to 14-year-old individuals participated (n = 75) in this study. OCT images were taken using an swept-source-OCT (SS-OCT) instrument (DRI-OCT Triton, Topcon, Tokyo, Japan). The early treatment diabetic retinopathy study (EDTRS) grid (6 × 6 mm) divided the RNFL into the thickness maps. The FD% values of the CC were calculated on the 3 × 3-mm scans in a 1-mm circle (C1), 1.5-mm rim (R1.5), and the entire 2.5-mm circle (C2.5), and on the 6 x 6-mm scans in a 1-mm circle (C1), 1.5-mm rim (R1.5), the entire 2.5-mm circle (C2.5), 2.5-mm rim (R2.5), and 5-mm circle (C5). Results: Both scan quantifications of FD% in the C1, C2.5, and R1.5 sectors were similar, but the 6 × 6-mm scan measurements were statistically significantly smaller than the 3 × 3-mm ones. Significant moderate correlations were found between axial length (AxL) and FD% in the 6 × 6-mm scans, namely C1 (r = −0.347, p = 0.002), C2.5 (r = −0.337, p = 0.003), R1.5 (r = −0.328, p = 0.004), R2.5 (r = −0.306, p = 0.008), and C5 (r = −0.314, p = 0.006). Conclusions: The thinnest RNFL layers were on the temporal and nasal sides. FD% values in the C1, C2.5, and R1.5 sectors were similar between the 3 × 3-mm and 6 × 6-mm scans. The negative moderate correlations between AxL and FD% were found in all C1, C2.5, C5, R1.5, and R2.5 sectors of the 6 × 6-mm scans. Further prospective studies are needed to determine more accurate normative references for children’s OCT parameters.

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“…It was not necessary to perform manual corrections; the Optovue XR Avanti (Fremont, CA) has active motion-tracking capability to minimize motion artifacts [21]. The OCT-A measurements were performed at the same time of the day (specifically, 3:00-5:00 pm) in both patients and controls [14,[22][23][24]. Thicknesses at the whole image, foveal, and parafoveal zone were measured by OCT [9,10,25].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of retinal microvascular perfusion in hereditary angioedema: a case-control study

Triggianese

Cesareo

Guarino

et al. 2020

Orphanet J Rare Dis

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Evidence supports that hereditary angioedema (HAE) may be considered as a paroxysmal permeability disorder with defective but self-limiting endothelial barrier dysfunction. A potential subclinical abnormal vascular permeability at retinal capillaries could induce damage resulting in retinopathy. We aimed at exploring for the first time the presence of microangiopathy at retinal level from a highly selective cohort of patients with HAE due to C1 esterase inhibitor protein (C1INH) deficiency (type I). We conducted a pilot, prospective, case-control study including 20 type I HAE patients and 20 age−/sex-matched healthy controls (HC). All participants underwent standard ophthalmological examination including visual fields. Superficial and deep capillary plexi in the retina were analyzed by using new optical coherence tomography angiography (OCT-A). A total of 40 eyes from 20 HAE patients and 20 eyes from HC were evaluated. Perimetric indices of visual field were slightly worse in HAE than in controls. OCT-angiograms documented in HAE patients a lower retinal capillary density in both superficial and deep scans and a higher retinal thickness compared to healthy eyes. Our findings firstly documented subclinical abnormalities in retinal microvascular network in type I HAE patients that might be associated with early subtle functional changes. This preliminary evidence supports the hypothesis of a recurrent endothelial barrier failure at retinal level in HAE patients potentially resulting in chronic damage.

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Evaluating diurnal changes in choroidal sublayer perfusion using optical coherence tomography angiography

Cited by 32 publications

References 46 publications

Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

Evaluating diurnal variations in retinal perfusion using optical coherence tomography angiography

Determination of Referential Rates for Optical Coherence Tomography and Optical Coherence Tomography Angiography Flow Deficits in the Macular Choriocapillaris in Ophthalmologically Healthy Children

Evaluation of retinal microvascular perfusion in hereditary angioedema: a case-control study

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