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1.
Microvasc Res ; 152: 104648, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38123065

RESUMEN

PURPOSE: To measure non-invasively retinal venous blood flow (RBF) in healthy subjects and patients with retinal venous occlusion (RVO). METHODS: The prototype named AO-LDV (Adaptive Optics Laser Doppler Velocimeter), which combines a new absolute laser Doppler velocimeter with an adaptive optics fundus camera (rtx1, Imagine Eyes®, Orsay, France), was studied for the measurement of absolute RBF as a function of retinal vessel diameters and simultaneous measurement of red blood cell velocity. RBF was measured in healthy subjects (n = 15) and patients with retinal venous occlusion (RVO, n = 6). We also evaluated two softwares for the measurement of retinal vessel diameters: software 1 (automatic vessel detection, profile analysis) and software 2 (based on the use of deep neural networks for semantic segmentation of vessels, using a M2u-Net architecture). RESULTS: Software 2 provided a higher rate of automatic retinal vessel measurement (99.5 % of 12,320 AO images) than software 1 (64.9 %) and wider measurements (75.5 ± 15.7 µm vs 70.9 ± 19.8 µm, p < 0.001). For healthy subjects (n = 15), all the retinal veins in one eye were measured to obtain the total RBF. In healthy subjects, the total RBF was 37.8 ± 6.8 µl/min. There was a significant linear correlation between retinal vessel diameter and maximal velocity (slope = 0.1016; p < 0.001; r2 = 0.8597) and a significant power curve correlation between retinal vessel diameter and blood flow (3.63 × 10-5 × D2.54; p < 0.001; r2 = 0.7287). No significant relationship was found between total RBF and systolic and diastolic blood pressure, ocular perfusion pressure, heart rate, or hematocrit. For RVO patients (n = 6), a significant decrease in RBF was noted in occluded veins (3.51 ± 2.25 µl/min) compared with the contralateral healthy eye (11.07 ± 4.53 µl/min). For occluded vessels, the slope between diameter and velocity was 0.0195 (p < 0.001; r2 = 0.6068) and the relation between diameter and flow was Q = 9.91 × 10-6 × D2.41 (p < 0.01; r2 = 0.2526). CONCLUSION: This AO-LDV prototype offers new opportunity to study RBF in humans and to evaluate treatment in retinal vein diseases.


Asunto(s)
Oclusión de la Vena Retiniana , Vena Retiniana , Humanos , Oclusión de la Vena Retiniana/diagnóstico , Flujo Sanguíneo Regional , Retina , Vasos Retinianos , Angiografía con Fluoresceína/métodos , Vena Retiniana/diagnóstico por imagen , Velocidad del Flujo Sanguíneo , Flujometría por Láser-Doppler
2.
Sens Diagn ; 2(4): 964-975, 2023 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-37465008

RESUMEN

Traumatic brain injuries (TBI) are typically acquired when a sudden violent event causes damage to the brain tissue. A high percentage (70-85%) of all TBI patients are suffering from mild TBI (mTBI), which is often difficult to detect and diagnose with standard imaging tools (MRI, CT scan) due to the absence of significant lesions and specific symptoms. Recent studies suggest that a screening test based on the measurement of a protein biomarker panel directly from a patient's blood can facilitate mTBI diagnosis. Herein, we report a novel prototype system designed as a precursor of a future hand-held point-of-care (POC) diagnostic device for the simultaneous multi-biomarker sensing, employing a microarray-type spatially resolved electrochemiluminescence immunoassay (SR-ECLIA). The small tabletop prototype consists of a screen-printed electrode compartment to conduct multi-analyte ECL sandwich assays, a potentiostat module and a light collection module, all integrated into a compact 3D-printed housing (18.2 × 16.5 × 5.0 cm), as well as an sCMOS detector. Based on this design concept, further miniaturization, system integration, performance optimization and clinical evaluation shall pave the way towards the development of a portable instrument for use at the site of accident and healthcare. To demonstrate the system's feasibility, current performance and efficiency, the simultaneous detection of three mTBI biomarkers (GFAP, h-FABP, S100ß) in 50% serum was achieved in the upper pg mL-1 range. The proposed device is amenable to the detection of other biomarker panels and thus could open new medical diagnostic avenues for sensitive multi-analyte measurements with low-volume biological sample requirements.

3.
J Opt Soc Am A Opt Image Sci Vis ; 38(9): 1312-1319, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-34613138

RESUMEN

For any given set of light sources stimulating the photoreceptors of the retina, the theoretical levels of illumination producing the smallest and the largest expression of one photoreceptor with fixed stimulation for the others are analytically computed. The cases of four, five, and more light sources are studied. We show that, for contrast optimization, only as many light sources as photoreceptors do matter and that, in the case of four light sources, the maximum contrast achievable for melanopsin lies at the intersection of the lines joining the sources in the CIE xy chromaticity diagram. This result is used to obtain the optimal position of four Gaussian primaries of equal bandwidth. In addition, we derive a procedure to construct level maps for melanopsin contrast overlying the diagram. In the second part of the paper, the interpersonal variability of the perceived stimulation is shown to be globally reduced if the bandwidth of the light sources is increased and, under some assumptions, if a light source is added.


Asunto(s)
Modelos Biológicos , Células Fotorreceptoras , Opsinas de Bastones , Humanos , Luz , Retina
4.
Acta Ophthalmol ; 99(8): e1375-e1381, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33650207

RESUMEN

PURPOSE: To investigate choroidal blood flow changes after isometric exercise in patients with chronic central serous chorioretinopathy nontreated or treated with mineralocorticoid receptor antagonists (MRA). METHODS: Foveolar choroidal laser Doppler flowmetry parameters - velocity (ChVel), volume (ChVol) and blood flow (ChBF) - of 22 eyes of 22 treated patients, 16 eyes of 16 untreated patients and 19 healthy controls were measured during a squatting test. Treatment consisted in MRA administration (eplerenone 50 mg/day or spironolactone 50 mg/day). The experiment comprised three successive periods: 30 seconds of rest, 2 min of continuous squatting exercise, and 150 seconds of recovery. Significance levels were calculated using a generalized estimating equation. RESULTS: During the squatting period, nontreated CSCR eyes had a similar change in ChVel (p = 0.8), ChVol (p = 0.8), ChBF (p = 0.5) and resistance to healthy eyes. Treated CSCR eyes exhibited significantly smaller changes in ChVel (-0.1 ± 11%, p = 0.04) than healthy eyes (6 ± 8%). No significant difference was found for ChVol and ChBF between the groups. The increase in ChVol from baseline in the nontreated CSCR group (4.4 ± 9%) was lower than that of treated group (6.7%±11%; p = 0.01). Finally, ChBF and ChVel changes in the CSCR groups were not significantly different. CONCLUSIONS: No abnormalities were detected in the changes in ChBF parameters during increased ocular perfusion pressure in nontreated CSCR patients compared with controls. MRA treatment in CSCR patients induced a significant reduction in ChBVel and an increase in ChBVol in response to isometric exercise, suggesting that MRA exerts effects on choroidal vascular changes.


Asunto(s)
Coriorretinopatía Serosa Central/tratamiento farmacológico , Coroides/irrigación sanguínea , Eplerenona/farmacología , Ejercicio Físico/fisiología , Flujo Sanguíneo Regional/efectos de los fármacos , Adulto , Coriorretinopatía Serosa Central/diagnóstico , Coriorretinopatía Serosa Central/fisiopatología , Coroides/diagnóstico por imagen , Enfermedad Crónica , Femenino , Estudios de Seguimiento , Humanos , Flujometría por Láser-Doppler , Masculino , Persona de Mediana Edad , Antagonistas de Receptores de Mineralocorticoides/farmacología , Estudios Prospectivos , Tomografía de Coherencia Óptica/métodos
5.
J Biomed Opt ; 25(11)2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33236618

RESUMEN

SIGNIFICANCE: The development of a technique allowing for non-invasive measurement of retinal blood flow (RBF) in humans is needed to understand many retinal vascular diseases (pathophysiology) and evaluate treatment with potential improvement of blood flow. AIM: We developed and validated an absolute laser Doppler velocimeter (LDV) based on an adaptive optical fundus camera that provides simultaneously high-definition images of the fundus vessels and absolute maximal red blood cells (RBCs) velocity to calculate the absolute RBF. APPROACH: This new absolute LDV is combined with the adaptive optics (AO) fundus camera (rtx1, Imagine Eyes©, Orsay, France) outside its optical wavefront correction path. A 4-s recording includes 40 images, each synchronized with two Doppler shift power spectra. Image analysis provides a vessel diameter close to the probing beam, and the velocity of the RBCs in the vessels are extracted from the Doppler spectral analysis. A combination of these values gives an average of the absolute RBF. RESULTS: An in vitro experiment consisting of latex microspheres flowing in water through a glass capillary to simulate a blood vessel and in vivo measurements on six healthy humans was done to assess the device. In the in vitro experiment, the calculated flow varied between 1.75 and 25.9 µL / min and was highly correlated (r2 = 0.995) with the flow imposed by a syringe pump. In the in vivo experiment, the error between the flow in the parent vessel and the sum of the flow in the daughter vessels was between -11 % and 36% (mean ± sd, 5.7 ± 18.5 % ). RBF in the main temporal retinal veins of healthy subjects varied between 0.9 and 13.2 µL / min. CONCLUSIONS: The AO LDV prototype allows for the real-time measurement of absolute RBF derived from the retinal vessel diameter and the maximum RBCs velocity in that vessel.


Asunto(s)
Flujómetros , Velocidad del Flujo Sanguíneo , Angiografía con Fluoresceína , Humanos , Flujometría por Láser-Doppler , Rayos Láser , Flujo Sanguíneo Regional , Vasos Retinianos/diagnóstico por imagen
6.
Acta Ophthalmol ; 96(7): e783-e788, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30203609

RESUMEN

PURPOSE: To analyse choroidal blood flow (ChBF) changes after the first intravitreal ranibizumab injection in naïve, age-related macular degeneration (ARMD) patients. METHODS: Subfoveal ChBF was assessed by laser Doppler flowmetry (LDF) in newly diagnosed ARMD patients. Both treated and untreated eyes were assessed in each subject at each visit before the first intravitreal ranibizumab injection as well as 24 hr (day 1) and 7 days after (day 7). Central macular thickness (CMT), best-corrected visual acuity (BVCA), systemic haemodynamic parameters and LDF parameters were evaluated at each visit. Nonparametric tests were used to compare data between visits and between treated and untreated eyes. RESULTS: Seventeen ARMD patients were included (12 women and five men, 78 ± 8 years old). At day 7 postintravitreal ranibizumab injection, the normalized choroidal blood velocity (ChBVel) change in the treated eye group was significant (-10.2%; p = 0.006). The choroidal blood volume (ChBVol) did not change significantly after intravitreal injection of ranibizumab. There was a trend for a reduction in ChBF at day 7 (-9.1%, p = 0.08). The sensitivity of the experiment was 12% for ChBVel, 16% for ChBVol and 9% for ChBF. CONCLUSION: In conclusion, the laser Doppler technique provides feasible and noninvasive measurements of blood flow parameters before and after intravitreal injection of antivascular endothelial growth factor (anti-VEGF) in patients with exudative ARMD. Choroidal blood velocity decreased as early as 7 days after intravitreal ranibizumab injection, suggesting a vasoconstriction effect of anti-VEGF in large choroidal vessels in front of choriocapillaris (the site of LDF measurement).


Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Coroides/irrigación sanguínea , Ranibizumab/uso terapéutico , Degeneración Macular Húmeda/tratamiento farmacológico , Degeneración Macular Húmeda/fisiopatología , Anciano , Anciano de 80 o más Años , Velocidad del Flujo Sanguíneo , Presión Sanguínea/fisiología , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intravítreas , Flujometría por Láser-Doppler , Masculino , Estudios Prospectivos , Flujo Sanguíneo Regional/fisiología , Tomografía de Coherencia Óptica , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual/fisiología
7.
Invest Ophthalmol Vis Sci ; 58(12): 5460-5467, 2017 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-29059313

RESUMEN

Purpose: To investigate the impact of different gas mixtures (hyperoxia, hypoxia, and hypercapnia) on the optic nerve head (ONH) and choroidal (Ch) hemodynamics. Methods: Twenty-three healthy subjects (28 ± 6 years) took part in the study. Variations in inspired oxygen and carbon dioxide fraction were produced by a gas mixing device. Arterial oxygen saturation (SpO2) was measured continuously using a transcutaneous sensor and end-tidal carbon dioxide partial pressure by capnography. The experiment comprised three successive periods: 3-minute baseline (room air breathing), 15-minute gas mixture inhalation (normocapnic hypoxia, hypercapnia, or hyperoxia), and 15-minute recovery (room air breathing). Laser Doppler flowmeter parameters-velocity (VEL), volume (VOL), and flow (BF) of red blood cells-were measured. Two-way ANOVAs were performed for statistical analysis. Results: In response to hyperoxia, ONHBF significantly decreased by -18% ± 6% (P = 0.04) from baseline, due to significant changes in VEL (-12% ± 3% P = 0.0002). During hypoxia at 85% SpO2, ONH VEL increased by +12% ± 3% (P = 0.0009), whereas VOL and BF did not change significantly. ChBF significantly increased by +7% ± 2% (P = 0.004) in response to hypoxia, due to significant changes in VEL +5% ± 2% (P = 0.03). Both Ch and ONHBFs did not vary significantly in response to hypercapnia. Conclusions: The magnitude of the blood flow response is the most significant during hyperoxia for ONH and hypoxia for ChBF. For ONHBF, a 37% difference between hyperoxia and hypoxia can be useful when vasoreactivity to O2 will be tested in patients.


Asunto(s)
Coroides/irrigación sanguínea , Hemodinámica/fisiología , Hipercapnia/fisiopatología , Hiperoxia/fisiopatología , Hipoxia/fisiopatología , Disco Óptico/irrigación sanguínea , Adulto , Velocidad del Flujo Sanguíneo , Presión Sanguínea , Dióxido de Carbono/sangre , Femenino , Voluntarios Sanos , Humanos , Presión Intraocular , Flujometría por Láser-Doppler , Masculino , Oxígeno/sangre , Flujo Sanguíneo Regional/fisiología
8.
Lab Chip ; 16(8): 1383-92, 2016 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-27001545

RESUMEN

Living bacteria or yeast cells are frequently used as bioreporters for the detection of specific chemical analytes or conditions of sample toxicity. In particular, bacteria or yeast equipped with synthetic gene circuitry that allows the production of a reliable non-cognate signal (e.g., fluorescent protein or bioluminescence) in response to a defined target make robust and flexible analytical platforms. We report here how bacterial cells expressing a fluorescence reporter ("bactosensors"), which are mostly used for batch sample analysis, can be deployed for automated semi-continuous target analysis in a single concise biochip. Escherichia coli-based bactosensor cells were continuously grown in a 13 or 50 nanoliter-volume reactor on a two-layered polydimethylsiloxane-on-glass microfluidic chip. Physiologically active cells were directed from the nl-reactor to a dedicated sample exposure area, where they were concentrated and reacted in 40 minutes with the target chemical by localized emission of the fluorescent reporter signal. We demonstrate the functioning of the bactosensor-chip by the automated detection of 50 µgarsenite-As l(-1) in water on consecutive days and after a one-week constant operation. Best induction of the bactosensors of 6-9-fold to 50 µg l(-1) was found at an apparent dilution rate of 0.12 h(-1) in the 50 nl microreactor. The bactosensor chip principle could be widely applicable to construct automated monitoring devices for a variety of targets in different environments.


Asunto(s)
Técnicas Biosensibles/instrumentación , Dispositivos Laboratorio en un Chip , Automatización , Dimetilpolisiloxanos , Diseño de Equipo , Escherichia coli/citología
9.
PLoS One ; 10(7): e0134378, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26226150

RESUMEN

PURPOSE: Noninvasive techniques for ocular blood perfusion assessment are of crucial importance for exploring microvascular alterations related to systemic and ocular diseases. However, few techniques adapted to rodents are available and most are invasive or not specifically focused on the optic nerve head (ONH), choroid or retinal circulation. Here we present the results obtained with a new rodent-adapted compact fundus camera based on laser Doppler flowmetry (LDF). METHODS: A confocal miniature flowmeter was fixed to a specially designed 3D rotating mechanical arm and adjusted on a rodent stereotaxic table in order to accurately point the laser beam at the retinal region of interest. The linearity of the LDF measurements was assessed using a rotating Teflon wheel and a flow of microspheres in a glass capillary. In vivo reproducibility was assessed in Wistar rats with repeated measurements (inter-session and inter-day) of retinal arteries and ONH blood velocity in six and ten rats, respectively. These parameters were also recorded during an acute intraocular pressure increase to 150 mmHg and after heart arrest (n = 5 rats). RESULTS: The perfusion measurements showed perfect linearity between LDF velocity and Teflon wheel or microsphere speed. Intraclass correlation coefficients for retinal arteries and ONH velocity (0.82 and 0.86, respectively) indicated strong inter-session repeatability and stability. Inter-day reproducibility was good (0.79 and 0.7, respectively). Upon ocular blood flow cessation, the retinal artery velocity signal substantially decreased, whereas the ONH signal did not significantly vary, suggesting that it could mostly be attributed to tissue light scattering. CONCLUSION: We have demonstrated that, while not adapted for ONH blood perfusion assessment, this device allows pertinent, stable and repeatable measurements of retinal blood perfusion in rats.


Asunto(s)
Flujometría por Láser-Doppler/métodos , Microvasos/fisiología , Flujo Sanguíneo Regional/fisiología , Vasos Retinianos/fisiología , Animales , Velocidad del Flujo Sanguíneo/fisiología , Fondo de Ojo , Presión Intraocular/fisiología , Masculino , Microvasos/ultraestructura , Disco Óptico/irrigación sanguínea , Ratas , Ratas Wistar , Vasos Retinianos/ultraestructura
10.
Rev Sci Instrum ; 85(1): 015120, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24517825

RESUMEN

We present a compact portable biosensor to measure arsenic As(III) concentrations in water using Escherichia coli bioreporter cells. Escherichia coli expresses green fluorescent protein in a linearly dependent manner as a function of the arsenic concentration (between 0 and 100 µg/L). The device accommodates a small polydimethylsiloxane microfluidic chip that holds the agarose-encapsulated bacteria, and a complete optical illumination/collection/detection system for automated quantitative fluorescence measurements. The device is capable of sampling water autonomously, controlling the whole measurement, storing and transmitting data over GSM networks. We demonstrate highly reproducible measurements of arsenic in drinking water at 10 and 50 µg/L within 100 and 80 min, respectively.


Asunto(s)
Arsénico/análisis , Técnicas Biosensibles/instrumentación , Escherichia coli/citología , Técnicas Analíticas Microfluídicas/instrumentación , Agua/química , Contaminantes Químicos del Agua/análisis
11.
Invest Ophthalmol Vis Sci ; 55(1): 485-91, 2014 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-24355824

RESUMEN

PURPOSE: This study investigates the effect of increased ocular perfusion pressure (OPP) on optic nerve head (ONH) hemodynamics. METHODS: In 21 healthy subjects, the increase in arterial blood pressure (BP), measured continuously using a pneumatic transcutaneous sensor, was produced by isometric exercise consisting of 2 minutes of hand-gripping. ONH blood flow parameters-namely the velocity (Vel), number (Vol), and flux (F) of red blood cells-were measured using the laser Doppler flowmeter (LDF). RESULTS: In those 14 healthy subjects who exhibited a similar increase in BP to handgrip superior to 30% of baseline BP, group average increases of BP and OPP amounted to 34% ± 3% (SEM) and 43% ± 3%, respectively. The increase in F of 19% ± 8%, resulting from an increase in Vel (17% ± 7%) and Vol (6% ± 7%), was significantly less than predicted for a passive autoregulatory response, as revealed also by the increase in vascular resistance (R = OPP/F). Spearman test of linear correlations between F and time during handgrip led to the identification of one group of eight subjects (with a stable F) and one group of six subjects (with an increase in F). A closed-loop gain (G) of the regulatory process, defined as G = 1 - {(F - Fbl)/Fbl}/{(OPP - OPPbl)/OPPbl}, was found to be rather independent from the OPP, with an average value 0.7 ± 0.07. G was 0.83 ± 0.06 for the group of eight subjects with stable F and 0.3 ± 0.15 for the group of six subjects with F increasing with the OPP. CONCLUSIONS: The continuous recording of both BP and LDFs represents a novel and more precise approach to the characterization of ONH hemodynamics during isometric exercise, especially useful in the future for patients with ocular diseases. The efficiency of the ONH blood flow autoregulation appears to vary significantly between healthy subjects. (ClinicalTrials.gov number, NCT00874913.).


Asunto(s)
Presión Sanguínea/fisiología , Ejercicio Físico/fisiología , Presión Intraocular/fisiología , Disco Óptico/irrigación sanguínea , Flujo Sanguíneo Regional/fisiología , Resistencia Vascular , Adolescente , Adulto , Femenino , Humanos , Hipertensión/fisiopatología , Flujometría por Láser-Doppler , Masculino , Valores de Referencia , Adulto Joven
12.
J Biomed Opt ; 18(12): 127001, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24296999

RESUMEN

We describe a device to measure blood perfusion for the human optic nerve head (ONH) based on laser Doppler flowmetry (LDF) with a flicker stimuli of the fovea region. This device is self-aligned for LDF measurements and includes near-infrared pupil observation, green illumination, and observation of the ONH. The optical system of the flowmeter is based on a Schlieren arrangement which collects only photons that encounter multiple scattering and are back-scattered out of the illumination point. LDF measurements are based on heterodyne detection of Doppler shifted back-scattered light. We also describe an automated analysis of the LDF signals which rejects artifacts and false signals such as blinks. By using a Doppler simulator consisting of a lens and a rotating diffusing wheel, we demonstrate that velocity and flow vary linearly with the speed of the wheel. A cohort of 12 healthy subjects demonstrated that flicker stimulation induces an increase of 17.8% of blood flow in the ONH.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Flujometría por Láser-Doppler/instrumentación , Flujometría por Láser-Doppler/métodos , Disco Óptico/irrigación sanguínea , Adulto , Femenino , Fondo de Ojo , Humanos , Masculino , Disco Óptico/fisiología , Estimulación Luminosa
13.
Curr Opin Biotechnol ; 24(3): 534-41, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22999825

RESUMEN

A wide variety of whole cell bioreporter and biosensor assays for arsenic detection has been developed over the past decade. The assays permit flexible detection instrumentation while maintaining excellent method of detection limits in the environmentally relevant range of 10-50 µg arsenite per L and below. New emerging trends focus on genetic rewiring of reporter cells and/or integration into microdevices for more optimal detection. A number of case studies have shown realistic field applicability of bioreporter assays.


Asunto(s)
Arsénico/análisis , Bioensayo/métodos , Técnicas Biosensibles/métodos , Biotecnología/métodos , Arsenitos/análisis , Técnicas Biosensibles/instrumentación
14.
Invest Ophthalmol Vis Sci ; 52(13): 9489-96, 2011 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-22025580

RESUMEN

PURPOSE: Obstructive sleep apnea (OSA) syndrome generates hypertension, atherosclerosis, and endothelial and autonomic dysfunction, which may mutually interact with ocular vascular regulation. Exercise and posture changes can be used to manipulate blood pressure, ocular perfusion pressure (OPP), or both. It was hypothesized that choroidal vascular reactivity in response to isometric exercise and posture changes could be altered in OSA patients. METHODS: Healthy men were matched 1:1 for body mass index, sex, and age with patients with newly diagnosed OSA without cardiovascular comorbidities. All subjects underwent sleep studies and cardiovascular phenotyping (24-hour blood pressure monitoring, arterial stiffness measurements, and cardiac and carotid echography). Choroidal reactivity was assessed by laser Doppler flowmetry, which measured subfoveal choroidal blood flow. RESULTS: During exercise, blood pressure parameters increased significantly within the same range, with a similar profile over time in OSA patients and control subjects. A significant linear relationship (P = 0.0003) was noted between choroidal vascular resistance and the OPP changes during exercise in OSA patients and control subjects. From the sitting to the supine position, a significant decrease in mean arterial pressure occurred in both groups (10.9%-13.4%; P < 0.001). In both populations, no significant change in choroidal blood flow or vascular resistance was found during the posture change. Choroidal blood flow responses to exercise and posture changes were unchanged after 6 to 9 months of continuous positive airway pressure treatment. CONCLUSIONS: This study strongly suggests that the regulation of choroidal blood flow, which depends on the orthosympathetic and parasympathetic systems, is unaltered in men with OSA who have no comorbidities.


Asunto(s)
Coroides/irrigación sanguínea , Ejercicio Físico/fisiología , Postura/fisiología , Apnea Obstructiva del Sueño/fisiopatología , Análisis de Varianza , Velocidad del Flujo Sanguíneo/fisiología , Presión Sanguínea/fisiología , Coroides/fisiopatología , Presión de las Vías Aéreas Positiva Contínua , Estudios Cruzados , Método Doble Ciego , Frecuencia Cardíaca/fisiología , Humanos , Presión Intraocular/fisiología , Masculino , Persona de Mediana Edad , Polisomnografía , Estudios Prospectivos , Flujo Sanguíneo Regional/fisiología , Apnea Obstructiva del Sueño/terapia , Resistencia Vascular/fisiología
15.
J Biomed Opt ; 16(4): 047004, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21529094

RESUMEN

A portable choroidal laser Doppler flowmeter (LDF) with enhanced sensitivity based on a scattering plate is developed. The portable LDF is weighted 2 kg operated at center wavelength of 780 nm, leading to a better penetration into the eye fundus in contrast to the previous LDF operated at center wavelength of 670 nm. Enhancement of number of detected photons that undergo Doppler scattering and improved measured speed of choroidal blood flow are achieved with the use of a scattering plate positioned in front of the eye. The mechanism of detection and sensitivity enhancement is theoretically analyzed. Evaluation of system performance is done by in vivo measurements on ten volunteers. The results demonstrate that an increased percentage of backscattering light at high Doppler shift frequency is collected due to utilization of the scattering plate. However, this kind of light detection influences spatial resolution of the system and decreases the total signal measured. The proposed method for detection and sensitivity enhancement might be useful in a case where the perception of very slight alternation of blood flow is pursued and the spatial resolution is not as critical as that in a choroidal vascular bed.


Asunto(s)
Coroides/irrigación sanguínea , Flujometría por Láser-Doppler/métodos , Diseño de Equipo , Humanos , Luz , Modelos Biológicos , Método de Montecarlo , Dispersión de Radiación , Sensibilidad y Especificidad
16.
Interact Cardiovasc Thorac Surg ; 12(5): 718-22, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21297131

RESUMEN

This observational study is conducted to demonstrate optic nerve head (ONH) blood flow alterations during extracorporeal circulation (ECC) in routine on-pump cardiovascular operations in order to evaluate the perfusion status of important autoregulatory tissue vascular beds during moderate hypothermia. Twenty-one patients free from eye disease were prospectively enrolled in our database. Perioperative ONH blood flow measurements were performed using a hand-held portable ocular laser Doppler flowmeter just after administration of general anesthesia and during cardiopulmonary bypass (CPB) upon the lowest temperature point of moderate hypothermia. Important operative flow variables were correlated to optic nerve blood flow during surgical phases. Statistical analysis showed significant reduction of 32.1 ± 14.5% of mean ONH blood flow in phase 2 (P < 0.0001) compared to the reference flow values of phase 1. A negative univariate association between ECC time and ONH blood flow in phase 2 (P = 0.031) is noted. This angiokinetic approach can detect changes of flow within autoregulatory vascular tissue beds like ONH, thus creating a 'window' on cerebral microvasculature. ONH blood flow is reduced during CPB. Our data suggest that it is of paramount importance to avoid extracorporeal prolongation even in moderate hypothermic cardiovascular operations.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Puente Cardiopulmonar , Circulación Cerebrovascular , Isquemia/diagnóstico por imagen , Flujometría por Láser-Doppler , Microcirculación , Monitoreo Intraoperatorio/métodos , Disco Óptico/irrigación sanguínea , Adulto , Anciano , Velocidad del Flujo Sanguíneo , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Puente Cardiopulmonar/efectos adversos , Diseño de Equipo , Femenino , Grecia , Homeostasis , Humanos , Hipotermia Inducida , Isquemia/etiología , Isquemia/fisiopatología , Flujometría por Láser-Doppler/instrumentación , Masculino , Persona de Mediana Edad , Monitoreo Intraoperatorio/instrumentación , Estudios Prospectivos , Flujo Sanguíneo Regional , Ultrasonografía
17.
Sleep ; 33(6): 811-8, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20550022

RESUMEN

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) impacts on macrovasculature and autonomic function and may therefore interfere with ocular microvascular regulation. We hypothesized that choroidal vascular reactivity to hyperoxia and hypercapnia was altered in patients with OSA compared with matched control subjects and would improve after treatment with continuous positive airway pressure (CPAP). METHODS: Sixteen healthy men were matched 1:1 for body mass index, sex, and age with 16 men with newly diagnosed OSA without comorbidities. Subjects underwent sleep studies, 24-hour blood pressure monitoring, arterial stiffness measurements, and cardiac and carotid echography. Overall, patients were middle-aged, lean, and otherwise healthy except for having OSA with a limited amount of desaturation, with, at most, subclinical lesions of the cardiovascular system, stage 1 hypertension, or both. Choroidal laser Doppler flowmetry provides a unique opportunity to assess microvascular function by measuring velocity, (ChBVel), volume (ChBVol), and relative subfoveal choroidal blood flow (ChBF). Vascular choroidal reactivity was studied during hyperoxia and hypercapnia (8% CO2) challenges before and after treatment with nasal CPAP. RESULTS: Patients with OSA and control subjects exhibited similar choroidal reactivity during hyperoxia (stability of choroidal blood flow) and hypercapnia (significant increases in ChBVel of 13.5% and in ChBF of 16%). Choroidal vasoreactivity to CO2 was positively associated with arterial stiffness in patients with OSA. Gas choroidal vasoreactivity was unchanged after 6 to 9 months of CPAP treatment. CONCLUSION: This study showed unimpaired choroidal vascular reactivity in otherwise healthy men with OSA. This suggests that patients with OSA, without comorbidities, have long-term adaptive mechanisms active in ocular microcirculation.


Asunto(s)
Coroides/irrigación sanguínea , Hipercapnia/fisiopatología , Hiperoxia/fisiopatología , Apnea Obstructiva del Sueño/fisiopatología , Administración por Inhalación , Análisis de Varianza , Dióxido de Carbono/administración & dosificación , Presión de las Vías Aéreas Positiva Contínua/métodos , Estudios Cruzados , Método Doble Ciego , Estudios de Seguimiento , Humanos , Hipercapnia/complicaciones , Hiperoxia/complicaciones , Flujometría por Láser-Doppler/métodos , Masculino , Microvasos , Persona de Mediana Edad , Oxígeno/administración & dosificación , Polisomnografía/métodos , Polisomnografía/estadística & datos numéricos , Estudios Prospectivos , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/terapia , Factores de Tiempo
18.
Retina ; 30(2): 275-80, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20175271

RESUMEN

PURPOSE: To evaluate the effect of hemodilution on subfoveal choroidal blood flow in the human eye with or without retinal vein occlusion. METHODS: Choroidal blood flow was measured using laser Doppler flowmetry in 28 patients with retinal vein occlusion in 1 eye. Isovolemic hemodilution was performed when hematocrit was >35%. Laser Doppler flowmetry parameters, velocity, volume, and flow were measured in both eyes in 4 sessions: 1 hour before and 1 hour after the first hemodilution on Day 1 and Day 7. RESULTS: Hematocrit decreased significantly by 23.7%, 19.8%, and 16.1% in the first hour, on the first day, and the seventh day after hemodilution, respectively (P < 0.001). The ocular perfusion pressure of the healthy eye and the eye with retinal vein occlusion decreased by 7.7% and 7.2% after 1 hour and by 5.3% and 4.7% 1 day after hemodilution, respectively (P < 0.01). After hemodilution, subfoveal choroidal blood velocity, volume, flow, and vascular resistance did not significantly change in either eye. CONCLUSION: Laser Doppler flowmetry measurement in the subfoveal choroid is a feasible technique for blood flow assessment in patients with retinal vein occlusion. A substantial change of hematocrit after isovolemic hemodilution does not lead to a significant change in choroidal blood flow. Vascular regulation is expected to keep blood flow constant and needs to be further explored.


Asunto(s)
Coroides/irrigación sanguínea , Hemodilución , Oclusión de la Vena Retiniana/fisiopatología , Velocidad del Flujo Sanguíneo/fisiología , Presión Sanguínea/fisiología , Femenino , Angiografía con Fluoresceína , Frecuencia Cardíaca/fisiología , Hematócrito , Humanos , Presión Intraocular/fisiología , Flujometría por Láser-Doppler , Masculino , Persona de Mediana Edad , Fenómenos Fisiológicos Oculares , Proyectos Piloto , Flujo Sanguíneo Regional , Tomografía de Coherencia Óptica , Agudeza Visual
19.
Acta Ophthalmol ; 88(6): 622-9, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19860779

RESUMEN

This article describes the technique of continuous laser Doppler flowmetry (LDF) as applied to the measurement of the flux of red blood cells in the optic nerve head, iris and subfoveal choroid. Starting with the exposition of the physical principles underlying LDF, we first describe the various devices developed to perform LDF in these vascular beds. We then discuss the clinical protocols, blood flow parameters, calibration procedures, reproducibility and limitations of the LDF technique. Various problems still need to be solved in order to bring to light the full potential of LDF in the assessment of microcirculatory haemodynamics.


Asunto(s)
Coroides/irrigación sanguínea , Oftalmopatías/fisiopatología , Iris/irrigación sanguínea , Flujometría por Láser-Doppler/métodos , Disco Óptico/irrigación sanguínea , Flujo Sanguíneo Regional/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Humanos
20.
Opt Express ; 15(5): 2683-90, 2007 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-19532505

RESUMEN

A new optical device to measure forward scattered light in a range of 3 degrees to 20 degrees has been developed and tested. The scattered light is focused on a plane where its axial position is proportional to the scattered angle theta. A motorized iris diaphragm located at this plane selects the scattered light between 0 degrees and a variable angle theta. This light is collected by an integrating sphere and converted into an electrical signal by an APD. The device was tested with suspensions of polystyrene microspheres of 3 different sizes. The obtained results are in good agreement with the Mie theory.

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