Retinal Oxygen Metabolism and Haemodynamics in Patients With Multiple Sclerosis and History of Optic Neuritis

Kallab, Martin; Hommer, Nikolaus; Schlatter, Andreas; Bsteh, Gabriel; Altmann, Patrick; Popa-Cherecheanu, Alina; Pfister, Martín; Werkmeister, René M.; Schmidl, Doreen; Schmetterer, Leopold; Garhöfer, Gerhard

doi:10.3389/fnins.2021.761654

Cited by 10 publications

(12 citation statements)

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“…This is of particular importance because oxygen metabolism and blood flow are strongly coupled, and hypoxia causes counterregulatory vasodilation (55). Furthermore, we have validated our approach in previous studies and successfully used this method to assess oxygen extraction in patients with type 1 diabetes (21) as well as in patients with systemic neurodegenerative and neuroinflammatory diseases (59,60).…”

Section: Discussionmentioning

confidence: 77%

Retinal Oxygen Metabolism in Patients With Type 2 Diabetes and Different Stages of Diabetic Retinopathy

et al. 2022

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The aim of the present study was to assess retinal oxygen metabolism in patients with type II diabetes and different stages of non-proliferative diabetic retinopathy (DR) and compare these findings to healthy controls. For this purpose, 67 patients with type II diabetes and 20 healthy controls were included in this cross-sectional study. 34 patients had no, 15 had mild and 18 had moderate to severe DR. Retinal oxygen saturation in arteries and veins was measured using the oxygen module of the Retinal Vessel Analyzer (RVA). Total retinal blood flow (TFBF) was measured using a custombuilt Doppler optical coherence tomography system. Retinal oxygen extraction was calculated out of retinal oxygen saturation and TRBF. Arteriovenous difference in oxygen saturation was highest in healthy subjects (34.9±7.5%), followed by patients with no DR (32.5±6.3%) and moderate to severe DR (30.3±6.5%). The lowest values were found in patients with mild DR (27.3±8.0%, p=0.010 vs. healthy subjects). TRBF tended to be higher in patients with no DR (40.1±9.2µl/min) and mild DR (41.8±15.0µl/min) compared to healthy subjects (37.2±5.7µl/min) and patients with moderate to severe DR (34.6±10.4µl/min). Retinal oxygen extraction was the highest in healthy subjects (2.24±0.57µl O2/min), followed by patients with no DR (2.14±0.6µl O2/min), patients with mild DR (1.90±0.77µl O2/min) and patients with moderate to severe DR (1.78±0.57µl O2/min, p=0.040 vs. healthy subjects). These results indicate that retinal oxygen metabolism is altered in patients with type II diabetes. Further, retinal oxygen extraction decreases with increasing severity of DR.

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Section: Discussionmentioning

confidence: 77%

Retinal Oxygen Metabolism in Patients With Type 2 Diabetes and Different Stages of Diabetic Retinopathy

et al. 2022

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“…Based on reflectometric measurements of the oxygen saturation in retinal vessels together with the determination of total retinal blood flow using Doppler optical coherence tomography, we can draw conclusions on the oxygen metabolism of the retina without invasive measurements. We have successfully used this approach in previous studies to investigate oxygen metabolisms in healthy subjects [ 55 , 56 ] as well as in pathological conditions [ 44 , 57 ]. As all techniques used in the current study are non-invasive and thus well tolerated, this approach is also suitable for larger studies.…”

Section: Discussionmentioning

confidence: 99%

Retinal Oxygen Extraction in Patients with Primary Open-Angle Glaucoma

Garhöfer

Bata

Popa-Cherecheanu

et al. 2022

IJMS

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Objective: To compare total retinal oxygen extraction between patients with primary open-angle glaucoma (POAG) and healthy control subjects. Design: A prospective, single-center, cross-sectional, case–control study performed at the Medical University of Vienna. Subjects: Forty patients with POAG and 40 age- and sex-matched control subjects. Methods: Total retinal blood flow was measured using Doppler optical coherence tomography (OCT). Retinal arterial and venous oxygen saturation was measured using reflectance spectroscopy. From these parameters, oxygen content in the retinal arterial and venous circulation as well as total retinal oxygen extraction were calculated. Results: Total retinal blood flow was lower in POAG (25.2 ± 6.7 µL/min) as compared to healthy control subjects (35.6 ± 8.3 µL/min, p < 0.001). Retinal arterial oxygen content was not different between the two groups (0.18 ± 0.01 mL(O2)/mL in both groups, p < 0.761), but retinal venous oxygen content was higher in POAG (0.15 ± 0.01 mL(O2)/mL) than in healthy controls (0.14 ± 0.01 mL(O2)/mL p < 0.001). Accordingly, retinal oxygen extraction was reduced in POAG (0.8 ± 0.3 µL(O2)/min as compared to healthy controls: 1.4 ± 0.4 µL(O2)/min, p < 0.001). There was a significant association between total retinal blood flow and total retinal oxygen extraction with measures of structural and functional damage (p < 0.001 each). Conclusions: This study indicates that POAG is associated with a reduction in total retinal oxygen extraction linked to structural and functional damage of the disease. Since the technology is non-invasive, it allows for longitudinal studies investigating to which degree low retinal oxygen extraction is linked to the progression of the disease.

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“…Therefore, we combined these results into a single study. Ultimately, this meta-analysis included 13 studies with 996 MS eyes and 847 HC eyes (Lanzillo et al, 2018;Feucht et al, 2019;Cennamo et al, 2020;Cordon et al, 2020;Farci et al, 2020;Murphy et al, 2020;Ulusoy et al, 2020;Yilmaz et al, 2020;Aly et al, 2021;Kallab et al, 2021;Khader et al, 2021;Montorio et al, 2021;Rogaczewska et al, 2021a,b). Murphy et al (2020) reported the results…”

Section: Included Studies and Main Characteristicsmentioning

confidence: 99%

“…stratified by image artifact grading, and we only included the data of minimal artifact in the quantitative analysis of meta-analysis. Among 13 included studies, four studies (Cordon et al, 2020;Farci et al, 2020;Kallab et al, 2021;Khader et al, 2021) analyzed monocular data, whereas nine studies (Lanzillo et al, 2018;Feucht et al, 2019;Cennamo et al, 2020;Murphy et al, 2020;Ulusoy et al, 2020;Yilmaz et al, 2020;Aly et al, 2021;Montorio et al, 2021;Rogaczewska et al, 2021a,b) analyzed biocular data. For patients with MS, the mean illness duration ranged from 4 to 11 years and the mean EDSS scores ranged from 1.0 to 3.5.…”

Section: Figurementioning

confidence: 99%

“…Nine studies (Cennamo et al, 2020;Cordon et al, 2020;Farci et al, 2020;Ulusoy et al, 2020;Yilmaz et al, 2020;Kallab et al, 2021;Khader et al, 2021;Montorio et al, 2021;Rogaczewska et al, 2021a), which included 941 eyes, reported data on the peripapillary vessel density (Supplementary Figure 3). The peripapillary density was 2.82% (95% CI −4.57 to −1.07%, P < 0.01) and 4.96% (95% CI −8.95 to −0.97%, P = 0.01) lower in the MSNON and MSON groups, respectively, than in the HC group.…”

Section: Outcome Measuresmentioning

confidence: 99%

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Microvascular impairments detected by optical coherence tomography angiography in multiple sclerosis patients: A systematic review and meta-analysis

Liu

Song

et al. 2023

Front. Neurosci.

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PurposeA systematic review and meta-analysis was conducted to investigate changes in retinal and choroidal microvasculature in patients with multiple sclerosis (MS) using optical coherence tomography angiography (OCTA).MethodsPubMed and Google Scholar were searched for studies that compared retinal and choroidal microvasculature between MS and healthy controls (HC) with OCTA. MS patients were divided into 2 groups: MS with (MSON) or without optic neuritis (MSNON).ResultsTotally, 13 studies including 996 MS eyes and 847 HC eyes were included. Compared with the HC, the vessel density of the whole superficial vascular complex (SVC) was reduced by 2.27% and 4.30% in the MSNON and MSON groups, respectively. The peripapillary vessel density was 2.28% lower and 4.96% lower in the MSNON and MSON groups, respectively, than in the HC. Furthermore, the MSON group had significant lower vessel density of the SVC (mean difference [MD] = −2.17%, P < 0.01) and lower peripapillary vessel density (MD = −2.02%, P = 0.02) than the MSNON group. No significant difference was found in the deep vascular complex or choriocapillaris densities among MSNON, MSON or HC groups (P > 0.05). Meta-regression analyses suggested that illness duration and the Expanded Disability Status Scale scores of MS patients were possible sources of heterogeneity (P < 0.05).ConclusionThe retinal SVC and peripapillary vessel density decreased significantly in MS eyes, especially in eyes with optic neuritis. Retinal microvasculature is a potential biomarker of disease progression in MS.

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Retinal Oxygen Metabolism and Haemodynamics in Patients With Multiple Sclerosis and History of Optic Neuritis

Cited by 10 publications

References 59 publications

Retinal Oxygen Metabolism in Patients With Type 2 Diabetes and Different Stages of Diabetic Retinopathy

Retinal Oxygen Metabolism in Patients With Type 2 Diabetes and Different Stages of Diabetic Retinopathy

Retinal Oxygen Extraction in Patients with Primary Open-Angle Glaucoma

Microvascular impairments detected by optical coherence tomography angiography in multiple sclerosis patients: A systematic review and meta-analysis

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