Widefield OCT-Angiography and Fluorescein Angiography Assessments of Nonperfusion in Diabetic Retinopathy and Edema Treated with Anti–Vascular Endothelial Growth Factor

Couturier, Aude; Rey, Pierre-Antoine; Erginay, Ali; Lavia, Carlo; Bonnin, Sophie; Dupas, B.; Gaudric, Alain; Tadayoni, Ramin

doi:10.1016/j.ophtha.2019.06.022

Cited by 159 publications

(133 citation statements)

References 26 publications

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“…Measuring retinal microvascular permeability has been mainly restricted to Miles-type assays using either fluorescent tracers or Evans Blue/albumin 8, 30 . Chronic leakage can also be visualised in real time by fluorescein angiography 31 . However, collectively these methods, which measure the amount of extravasated tracer, do not only reflect the degree of leakage but are also strongly influenced by dye concentration in the vasculature and dye clearance from the tissue 1, 2 .…”

Section: Discussionmentioning

confidence: 99%

AMP-activated protein kinase is a key regulator of acute neurovascular permeability

Dragoni

Caridi

Karatsai

et al. 2019

Preprint

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12Pathological hyperpermeability accompanies many blinding retinopathies. Despite 13 important therapeutic breakthroughs benefitting many but not all retinopathy patients, 14 the intracellular signalling underlying retinal leakage is still poorly understood. We 15 have developed an ex-vivo model, which allowed us to measure and manipulate acute 16 vascular permeability in the intact rodent retina, and combined measurements with 17 immunohistochemical analyses of signal transduction. This ex-vivo retina platform 18 proved to be an easily accessible and reliable tool for systematic identification of 19 regulators of vascular permeability through small molecule antagonists/agonists and 20 siRNA. By using this model, we showed that AMPK was a key mediator of VEGF-and 21 bradykinin-induced permeability by acting downstream of Ca 2+ and CAMKK, and 22 upstream of eNOS/VE-cadherin as well as p38/HSP27. Accordingly, AMPK agonist 23 potently induced retinal vascular leakage, a finding of major importance for their use 24 as therapeutic agents in the treatment of e.g. cancer or metabolic syndrome. 25 26 489 490 1 Nagy, 500 5 Ford, J. A. et al. Current treatments in diabetic macular oedema: systematic review and meta-501 analysis. BMJ Open 3, 504 7 Canning, P. et al. Lipoprotein-associated phospholipase A2 (Lp-PLA2) as a therapeutic target 505 to prevent retinal vasopermeability during diabetes. of phospholipase C, protein 510 kinase C, and calcium in VEGF-induced venular hyperpermeability. Am J Physiol 276, H535-511 542,

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Section: Discussionmentioning

confidence: 99%

AMP-activated protein kinase is a key regulator of acute neurovascular permeability

Dragoni

Caridi

Karatsai

et al. 2019

Preprint

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“…Detecting and assessing the surface of capillary non-perfusion areas is a critical prognostic factor in many retinal vascular diseases, especially in diabetic retinopathy and retinal vein occlusion [10][11][12][13] . This objective has been partially met using ultra-widefield fluorescein angiography (FA), but its resolution in the periphery is insufficient to accurately measure capillary non-perfusion areas compared to WF-OCTA 14 . OCTA also has the advantage of examining separately each of the different capillary plexuses as well as providing a detailed analysis of the foveal avascular zone (FAZ) 15,16 . Image montage.…”

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confidence: 99%

Retinal Capillary Plexus Pattern and Density from Fovea to Periphery Measured in Healthy Eyes with Swept-Source Optical Coherence Tomography Angiography

Lavia

Mecê

Nassisi

et al. 2020

Sci Rep

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Optical coherence tomography angiography is evolving towards wider fields of view. As single widefield acquisitions have a lower resolution, preventing an accurate segmentation of vascular plexuses in the periphery, we examined the retinal vascularisation from the macula to the periphery in all retinal quadrants, using 3 × 3-mm volume scans, to obtain montages with sufficient image resolution up to 11 mm from the foveal centre. Images were qualitatively and quantitatively analysed, using C-and B-scan approaches to calculate the capillary density (CD) and the interplexus distance (IPD). three vascular plexuses (i.e., superficial vascular plexus: SVP, intermediate capillary plexus: ICP, and deep capillary plexus: DCP) were observed up to the mid-periphery in all sectors. The CD of the SVP decreased from about 5 mm of eccentricity, along with ganglion cell density decrease. The CD of the icp progressively decreased from the fovea towards the periphery, along with the retinal thinning and then vanished from 8 to 9 mm of eccentricity, becoming undetectable beyond. This ICP disappearance resulted in an increased IPD between the SVP and the DCP in an area known to be frequently affected by capillary drop-out in diabetic retinopathy. The DCP only showed a slightly decreased CD towards the retinal periphery.Thus, it becomes important to better know the morphology, distribution and density of the different capillary plexuses from the fovea to the periphery. However, although WF-OCTA provides an image of the whole retinal capillary network that is qualitatively better than FA images, the resolution and segmentation of each capillary plexus with wider scans (i.e., 12 × 12-mm C-scans) is not sufficient to reliably assess the capillary plexuses and measure the capillary density (CD) 17,18 .The aim of this study was to evaluate the normal retinal vascularisation from the fovea to the far periphery. To overcome some of the limitations of wider scans, montages of small-field (3 × 3-mm) OCTA C-scans were used to provide a better resolution and fewer segmentation artefacts. MethodsDemographics. This study, conducted in the

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“…zu späte Zeitpunkt der Laserkoagulation oder der komplexe, nicht lineare Zusammenhang zwischen peripherer und zentraler Perfusion sein [257]. Im Falle einer Anti-VEGF-Therapie bei Ischämie wird die schlechte Perfusion nicht grundsätzlich verbessert [258,259]. Es muss daher daran gedacht werden, dass eine Regression bestehender Neovaskularisationen oft nur vorübergehend sein kann und auch keine Sicherheit vor einer Progression der Ischämien erwartet werden darf.…”

Section: 1-2 Ivom-therapie Mit Steroidenunclassified

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

2020

Klin Monatsbl Augenheilkd

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Widefield OCT-Angiography and Fluorescein Angiography Assessments of Nonperfusion in Diabetic Retinopathy and Edema Treated with Anti–Vascular Endothelial Growth Factor

Cited by 159 publications

References 26 publications

AMP-activated protein kinase is a key regulator of acute neurovascular permeability

AMP-activated protein kinase is a key regulator of acute neurovascular permeability

Retinal Capillary Plexus Pattern and Density from Fovea to Periphery Measured in Healthy Eyes with Swept-Source Optical Coherence Tomography Angiography

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

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