Measurement of Retinal Vascular Caliber From Optical Coherence Tomography Phase Images.

PURPOSE: To compare retinal vessel calibers extracted from phase-sensitive optical coherence tomography (OCT) images with vessel calibers as obtained from the Retinal Vessel Analyzer (RVA). METHODS: Data from previously published studies in 13 healthy subjects breathing room air (n = 214 vessels) and 7 subjects breathing 100% oxygen (n = 101 vessels) were used. Vessel calibers from OCT phase images were measured vertically along the optical axis by three independent graders. The data from RVA fundus images were corrected for magnification to obtain absolute values. RESULTS: The average vessel diameter as obtained from OCT images during normoxia was lower than from RVA images (83.8 ± 28.2 µm versus 86.6 ± 28.0 µm, P < 0.001). The same phenomenon was observed during 100% oxygen breathing (OCT: 81.0 ± 22.4 µm, RVA: 85.5 ± 26.0 µm; P = 0.001). Although the agreement between the two methods was generally high, the difference in individual vessels could be as high as 40%. These differences were neither dependent on absolute vessel size nor preferably found in specific subjects. Interobserver differences between OCT evaluators were much lower than differences between the techniques. CONCLUSIONS: Extracting vessel calibers from OCT phase images may be an attractive approach to overcome some of the problems associated with fundus imaging. The source of differences in vessel caliber between the two methods remains to be investigated. In addition, it remains unclear whether OCT-based vessel caliber measurement is superior to fundus camera-based imaging in risk stratification for systemic or ocular disease. (ClinicalTrials.gov numbers, NCT00914407, NCT02531399.).

Retinal oxygen extraction in humans.

Adequate function of the retina is dependent on proper oxygen supply. In humans, the inner retina is oxygenated via the retinal circulation. We present a method to calculate total retinal oxygen extraction based on measurement of total retinal blood flow using dual-beam bidirectional Doppler optical coherence tomography and measurement of oxygen saturation by spectrophotometry. These measurements were done on 8 healthy subjects while breathing ambient room air and 100% oxygen. Total retinal blood flow was 44.3 ± 9.0 µl/min during baseline and decreased to 18.7 ± 4.2 µl/min during 100% oxygen breathing (P < 0.001) resulting in a pronounced decrease in retinal oxygen extraction from 2.33 ± 0.51 µl(O2)/min to 0.88 ± 0.14 µl(O2)/min during breathing of 100% oxygen. The method presented in this paper may have significant potential to study oxygen metabolism in hypoxic retinal diseases such as diabetic retinopathy.

Blood flow velocity vector field reconstruction from dual-beam bidirectional Doppler OCT measurements in retinal veins.

In this paper, we demonstrate the possibility to reconstruct the actual blood flow velocity vector field in retinal microvessels from dual-beam bidirectional Doppler optical coherence tomography measurements. First, for a better understanding of measured phase patterns, several flow situations were simulated on the basis of the known dual beam measurement geometry. We were able to extract the vector field parameters that determine the measured phase pattern, allowing for the development of an algorithm to reconstruct the velocity vector field from measured phase data. In a next step, measurements were performed at a straight vessel section and at a venous convergence; the obtained phase data were evaluated by means of the new approach. For the straight vessel section, the reconstructed flow velocity vector field yielded a parabolic flow. For the venous convergence, however, the reconstructed vector field deviated from a parabolic profile, but was in very good accordance with the simulated vector field for the given vessel geometry. The proposed algorithm allows predictions of the velocity vector field. Moreover, the algorithm is also sensitive to directional changes of the flow velocity as small as <1°, thereby offering insight in the flow characteristics of the non-Newtonian fluid blood in microvessels.

Measurement of the total retinal blood flow using dual beam Fourier-domain Doppler optical coherence tomography with orthogonal detection planes.

We present a system capable of measuring the total retinal blood flow using a combination of dual beam Fourier-domain Doppler optical coherence tomography with orthogonal detection planes and a fundus camera-based retinal vessel analyzer. Our results show a high degree of conformity of venous and arterial flows, which corroborates the validity of the measurements. In accordance with Murray's law, the log-log regression coefficient between vessel diameter and blood flow was found to be ~3. The blood's velocity scaled linearly with the vessel diameter at higher diameters (> 60 µm), but showed a clear divergence from the linear dependence at lower diameters. Good agreement with literature data and the large range and high measurement sensitivity point to a high potential for further investigations.