Macular and peripapillary retinal nerve fibre layer thickness in patients with cyanotic congenital heart disease

Remígio, Maria Cecília de Aguiar; Brandt, Carlos Teixeira; Santos, Cleusa Cavalcanti Lapa; Arantes, Tiago Eugênio Faria e; Aguiar, Maria Inês Remígio de

doi:10.1038/eye.2014.330

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…In the group of CHD patients compared to the control, FT was 239.2 μm versus 242 μm ( p = 0.2), and PFT was 307 μm versus 311 μm ( p = 0.28). De Aguiar Remigio et al [ 59 ] reported significant reduction in FT (187.0 ± 4.4 μm vs. 236.9 ± 2.7 μm, p < 0.001) in children with cyanotic congenital heart disease compared to controls. In contrast, Aydi et al [ 60 ] found no reduction in central macular thickness in patients with cardiovascular risk factors that included previous acute myocardial infarction, acute coronary syndrome, coronary revascularization (with a stent or coronary artery bypass graft), or significant plaque on coronary angiography.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

Rakusiewicz

Kanigowska

Hautz

et al. 2021

JCM

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(1) Introduction: The aim of this study is to assess retinal vessel density (VD) in the superficial capillary plexus layer (SP) and deep capillary plexus layer (DP) in children with chronic heart failure (CHF) in the course of dilated cardiomyopathy (DCM) using optical coherence tomography angiography (OCTA). (2) Methods: Thirty children with CHF due to DCM lasting more than six months, with an enlarged left ventricle and impaired left ventricular systolic function (left ventricular ejection fraction (LVEF) ≤ 55%), were enrolled to have both their eyes assessed for this study. Mean age of the children was 9.9 ± 3.57 years. The control group consisted of an additional 30 children without CHF (mean age 11.27 ± 3.33 years) matched for age and gender against the study group. All participants underwent transthoracic echocardiography to measure LVEF using Simpson method. Blood serum was tested for N-terminal-pro-brain natriuretic peptide (NT-proBNP) marker value. All children underwent OCTA with evaluation of the foveal avascular zone (FAZ), whole superficial vessel density (wsVD), foveal superficial vessel density (fsVD), parafoveal superficial vessel density (psVD), whole deep vessel density (wdVD), foveal deep vessel density (fdVD), parafoveal deep vessel density (pdVD), whole thickness (WT), foveal thickness (FT), and parafoveal thickness (PFT). (3) Results: Retinal VD in SP was significantly lower in children with CHF as compared to the controls. The following SP parameters in the study group were statistically significantly lower than these same measurements for the control group. Details, with study group findings quantified first, include wsVD (46.2% vs. 49.83%, p < 0.05), fsVD (18.07% vs. 24.15%, p < 0.05), and psVD (49.24% vs. 52.51%, p < 0.05). The WT (311.03 micrometers (μm) vs. 323.55 μm, p < 0.05), FT (244.57 μm vs. 256.98 μm, p < 0.05), and PFT (320.63 μm vs. 332.02 μm, p < 0.05). No significant differences in DP retinal VD were found between the two groups. No statistically significant differences in the FAZ were found. The fsVD and FT were correlated with biometry and the age of the study participants. There was a correlation between FAZ and FT (p < 0.001). There were no correlations between retinal VD in both plexuses and refractive error, sex, NT-proBNP, and LVEF. (4) Conclusions: In children with CHF in the course of DCM as compared to the control group, significantly decreased retinal VD in SP was observed. The results of our study indicate that measurements of the OCTA may be a useful diagnostic method in children with chronic heart failure, but it is necessary to conduct further studies in larger groups of participants and long-term observation of these patients.

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Section: Discussionmentioning

confidence: 99%

The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

Rakusiewicz

Kanigowska

Hautz

et al. 2021

JCM

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“… 15 The scanning software also computed a signal strength index (SSI) value based on the volumetric OCT reflectance signal. Signal strength index has often been used as an indicator of scan quality, 16 – 18 with higher values being better.…”

Section: Methodsmentioning

confidence: 99%

Compensation for Reflectance Variation in Vessel Density Quantification by Optical Coherence Tomography Angiography

Gao

Jia

Liu

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PurposeTo compensate for reflectance variation when quantifying vessel density by optical coherence tomography angiography (OCTA).MethodsHealthy participants received 6×6-mm macular and 4.5×4.5-mm optic nerve head (ONH) angiography scans on a 70-kHz spectral-domain optical coherence tomography system. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute the OCTA signal. Mean reflectance projection and maximum decorrelation projection were used to create en face OCT and OCTA images. Background OCTA noise in static tissue was evaluated in the foveal avascular zone (FAZ). Vessel density was calculated from en face retinal OCTA that was binarized according to a decorrelation threshold.ResultsThe average retinal decorrelation noise in the FAZ was linearly related to the average logarithmic-scale OCT reflectance signal. Based on this relationship, a reflectance-adjusted decorrelation threshold equation was developed to filter out 97.5% of background OCTA noise. A fixed threshold was also used for comparison. The superficial vascular complex vessel density in the macula and ONH were significantly correlated with reflectance signal strength index (SSI) using the fixed threshold. This correlation was removed by using the reflectance-adjusted threshold. Reflectance compensation reduced population variation in 25 healthy eyes from 8.5% to 4.8% (coefficient of variation) in the macula and from 6.7% to 5.4% in the peripapillary region. Within-visit repeatability also improved from 4.4% to 1.8% in the macula and from 3% to 1.7% in the peripapillary region.ConclusionsCompensating for reflectance variation resulted in more reliable vessel density quantification in OCTA.

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“…Moreover, cyanosis also affects macular and retinal nerve fibre layer thickness. de Aguiar Remigio et al 17 showed a decrease in macular thickness; this is possibly as a result of the low oxygen supply as haemodynamic regulation is essential for retinal function. We have previously found global retinal nerve fibre layer thickness below the normal range in half of our study cohort (6/13); however, owing to a small sample size, these results were not significantly different from controls 7 .…”

Section: Cyanotic Chdmentioning

confidence: 99%

The eye in CHD

et al. 2018

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In recent years, there has been a rise in the number patients with CHD surviving into adulthood. Many have complications related to their CHD or its treatments, outside the heart, including ocular abnormalities. The objective of this review is to highlight the ocular abnormalities that occur in adults with CHD, either from their condition or related to the common drugs prescribed to manage it. In particular, we reviewed the effects of cyanosis, coarctation of the aorta, endocarditis, and the side effects of Sildenafil and Amiodarone. A change in the retinal vasculature is a common observation with cyanosis or coarctation of the aorta. Occlusion of the retinal vessels may also be observed in cyanotic patients, as well as those with infectious endocarditis. Sildenafil has established ocular side effects; here they are explored in the context of therapy for pulmonary hypertension. Similarly, Amiodarone has established ocular risks, which are summarised. The high prevalence of ocular consequences in adult CHD patients reinforces the need for knowledge of the risks involved and for frequent ophthalmological screening where appropriate.

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Macular and peripapillary retinal nerve fibre layer thickness in patients with cyanotic congenital heart disease

Cited by 9 publications

References 26 publications

The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

The Impact of Chronic Heart Failure on Retinal Vessel Density Assessed by Optical Coherence Tomography Angiography in Children with Dilated Cardiomyopathy

Compensation for Reflectance Variation in Vessel Density Quantification by Optical Coherence Tomography Angiography

The eye in CHD

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