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1.
BMJ Case Rep ; 17(5)2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38719246

RESUMO

Cutis marmorata telangiectatica congenita is a rare congenital vascular malformation characterised by cutaneous vascular abnormalities, typically diagnosed at birth or in the early postnatal period. Although typically benign, this disease is associated with other systemic abnormalities, including rare ocular alterations, such as congenital glaucoma, cataracts and retinopathy.This manuscript describes a female infant, who presented with generalised livedo reticularis, a band of alopecia and cutaneous atrophy in the temporal region above the coronal suture. The patient was diagnosed with cutis marmorata telangiectatica congenita by a paediatrician, and an ophthalmological evaluation was requested. A funduscopy examination in both eyes showed temporal and superior retina with avascular areas with new vessels, venous dilations and shunts, and no retinal detachments. Given these findings, we performed retinal photocoagulation laser treatment with excellent results.This case report highlights the importance of early ophthalmological evaluation of children with this disease to prevent secondary complications, such as vitreous haemorrhage and tractional retinal detachment.


Assuntos
Livedo Reticular , Dermatopatias Vasculares , Telangiectasia , Humanos , Feminino , Telangiectasia/congênito , Telangiectasia/complicações , Telangiectasia/diagnóstico , Dermatopatias Vasculares/diagnóstico , Dermatopatias Vasculares/complicações , Lactente , Fotocoagulação a Laser/métodos , Vasos Retinianos/anormalidades , Vasos Retinianos/diagnóstico por imagem , Retina/anormalidades , Retina/diagnóstico por imagem
2.
Vestn Oftalmol ; 140(2): 63-70, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38742500

RESUMO

PURPOSE: This study analyzes the main changes in retinal microcirculation in patients with multiple sclerosis (MS) and their relationship with the type of disease course. MATERIAL AND METHODS: 159 patients (318 eyes) were examined. The groups were formed according to the type of course and duration of MS: group 1 - 37 patients (74 eyes; 23.27%) with relapsing-remitting MS (RRMS) less than 1 year; group 2 - 47 patients (94 eyes; 29.56%) with RRMS from 1 year to 10 years; group 3 - 44 patients (86 eyes; 27.05%) with RRMS >10 years; group 4 - 32 patients (64 eyes; 20.12%) with secondary progressive MS (SPMS). Subgroups A and B were allocated within each group depending on the absence or presence of optic neuritis (ON). Patients underwent standard ophthalmological examination, including optical coherence tomography angiography (OCTA). RESULTS: A decrease in the vessel density (wiVD) and perfusion density (wiPD) in the macular and peripapillary regions was revealed, progressing with the duration of the disease and with its transition to the progressive type. The minimum values were observed in patients with SPMS (group 4), with the most pronounced in the subgroup with ON (wiVD = 16.06±3.65 mm/mm2, wiPD = 39.38±9.46%, ppwiPD = 44.06±3.09%, ppwiF = 0.41±0.05). CONCLUSION: OCTA provides the ability to detect subclinical vascular changes and can be considered a comprehensive, reliable method for early diagnosis and monitoring of MS progression.


Assuntos
Progressão da Doença , Esclerose Múltipla , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/fisiopatologia , Vasos Retinianos/diagnóstico por imagem , Angiofluoresceinografia/métodos , Microcirculação/fisiologia , Neurite Óptica/diagnóstico , Neurite Óptica/etiologia , Neurite Óptica/diagnóstico por imagem , Neurite Óptica/fisiopatologia , Reprodutibilidade dos Testes
3.
Ophthalmol Retina ; 8(2): 204-206, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38707762

RESUMO

Oral ingestion of fluorescein can be done in ambulatory pediatric clinics. We show that oral ultra-widefield fluorescein angiography is a non-invasive approach to rapidly diagnose and manage a diverse set of pediatric retinal vascular diseases.


Assuntos
Angiofluoresceinografia , Fluoresceína , Fundo de Olho , Doenças Retinianas , Humanos , Angiofluoresceinografia/métodos , Criança , Doenças Retinianas/diagnóstico , Fluoresceína/administração & dosagem , Masculino , Feminino , Adolescente , Vasos Retinianos/diagnóstico por imagem , Pré-Escolar , Instituições de Assistência Ambulatorial , Administração Oral
4.
Alzheimers Res Ther ; 16(1): 100, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711107

RESUMO

BACKGROUND: Retinal microvascular signs are accessible measures of early alterations in microvascular dysregulation and have been associated with dementia; it is unclear if they are associated with AD (Alzheimer's disease) pathogenesis as a potential mechanistic link. This study aimed to test the association of retinal microvascular abnormalities in mid and late life and late life cerebral amyloid. METHODS: Participants from the ARIC-PET (Atherosclerosis Risk in Communities-Positron Emission Tomography) study with a valid retinal measure (N = 285) were included. The associations of mid- and late-life retinal signs with late-life amyloid-ß (Aß) by florbetapir PET were tested. Two different measures of Aß burden were included: (1) elevated amyloid (SUVR > 1.2) and (2) continuous amyloid SUVR. The retinal measures' association with Aß burden was assessed using logistic and robust linear regression models. A newly created retinal score, incorporating multiple markers of retinal abnormalities, was also evaluated in association with greater Aß burden. RESULTS: Retinopathy in midlife (OR (95% CI) = 0.36 (0.08, 1.40)) was not significantly associated with elevated amyloid burden. In late life, retinopathy was associated with increased continuous amyloid standardized value uptake ratio (SUVR) (ß (95%CI) = 0.16 (0.02, 0.32)) but not elevated amyloid burden (OR (95%CI) = 2.37 (0.66, 9.88)) when accounting for demographic, genetic and clinical risk factors. A high retinal score in late life, indicating a higher burden of retinal abnormalities, was also significantly associated with increased continuous amyloid SUVR (ß (95% CI) = 0.16 (0.04, 0.32)) independent of vascular risk factors. CONCLUSIONS: Retinopathy in late life may be an easily obtainable marker to help evaluate the mechanistic vascular pathway between retinal measures and dementia, perhaps acting via AD pathogenesis. Well-powered future studies with a greater number of retinal features and other microvascular signs are needed to test these findings.


Assuntos
Peptídeos beta-Amiloides , Compostos de Anilina , Encéfalo , Tomografia por Emissão de Pósitrons , Vasos Retinianos , Humanos , Feminino , Masculino , Peptídeos beta-Amiloides/metabolismo , Tomografia por Emissão de Pósitrons/métodos , Idoso , Pessoa de Meia-Idade , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Vasos Retinianos/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/metabolismo , Microvasos/diagnóstico por imagem , Microvasos/metabolismo , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/metabolismo , Etilenoglicóis
5.
BMC Ophthalmol ; 24(1): 208, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38715011

RESUMO

BACKGROUND: To find the relationship between the changes of retinal and choriodal structure/ vascular densities (VD) and the myopia progress. METHODS: 126 eyes of 126 age-matched young participants were divided into three groups: Emmetropia and Low Myopia (EaLM) (33 eyes), Moderate Myopia (MM) (39 eyes), and High Myopia (HM) (54 eyes). Fundus images measuring 12 × 12 mm were captured using ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA). Each image was uniformly divided into nine regions: supra-temporal (ST), temporal (T), infra-temporal (IT), superior (S), central macular area (C), inferior (I), supra-nasal (SN), nasal (N), and infra-nasal (IN). Various structural parameters, including inner retina thickness (IRT), outer retina thickness (ORT), and choroid thickness (CT), were assessed, and the VD of the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaries (CC), and choroid vessels (ChdV) were quantified. RESULTS: CT in upper fundus exhibited a significant reduction from EaLM to MM. Additionally, ORT (ST, S. SN, C, N, IT, I, IN), CT (ST, S, SN, T, C, N, IT, I, IN) and VDs of SCP (ST, S, C, I, IN), DCP (ST, S, T, C, I) and ChdV (T, N, I, IN) were statistically diminished in EaLM compared to HM. Furthermore, IRT (N), ORT (N, IN), CT (S, SN, T, C, IT, I) and VDs of SCP (I, IN) and DCP (I) exhibited significant decreases as MM progressed towards HM. Intriguingly, there was a notable increase in the VD of CC (ST, S, T, C, N) as myopia progressed from MM to HM. CONCLUSION: Significant changes in retinal and choroid structure and vascular density occur as moderate myopia advances to high myopia. Efforts to curb myopia progression to this stage are essential, as the failure to do so may lead to the development of corresponding retinopathy.


Assuntos
Corioide , Angiofluoresceinografia , Miopia , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Corioide/irrigação sanguínea , Corioide/diagnóstico por imagem , Corioide/patologia , Masculino , Feminino , Adulto Jovem , Miopia/fisiopatologia , Adulto , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Angiofluoresceinografia/métodos , Retina/diagnóstico por imagem , Retina/patologia , Progressão da Doença , Adolescente , Fundo de Olho
6.
Sci Rep ; 14(1): 10306, 2024 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-38705883

RESUMO

Multiple ophthalmic diseases lead to decreased capillary perfusion that can be visualized using optical coherence tomography angiography images. To quantify the decrease in perfusion, past studies have often used the vessel density, which is the percentage of vessel pixels in the image. However, this method is often not sensitive enough to detect subtle changes in early pathology. More recent methods are based on quantifying non-perfused or intercapillary areas between the vessels. These methods rely upon the accuracy of vessel segmentation, which is a challenging task and therefore a limiting factor for reliability. Intercapillary areas computed from perfusion-distance measures are less sensitive to errors in the vessel segmentation since the distance to the next vessel is only slightly changing if gaps are present in the segmentation. We present a novel method for distinguishing between glaucoma patients and healthy controls based on features computed from the probability density function of these perfusion-distance areas. The proposed approach is evaluated on different capillary plexuses and outperforms previously proposed methods that use handcrafted features for classification. Moreover the results of the proposed method are in the same range as the ones of convolutional neural networks trained on the raw input images and is therefore a computationally efficient, simple to implement and explainable alternative to deep learning-based approaches.


Assuntos
Glaucoma , Vasos Retinianos , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Humanos , Glaucoma/diagnóstico por imagem , Glaucoma/diagnóstico , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Processamento de Imagem Assistida por Computador/métodos , Capilares/diagnóstico por imagem , Capilares/patologia
7.
BMC Ophthalmol ; 24(1): 201, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38698363

RESUMO

BACKGROUND: We aimed to employ Optical Coherence Tomography Angiography (OCTA) to comprehensively assess changes in the optic nerve head (ONH) and macular perfusion before and after the Corneal Collagen Cross-Linking (CCL) procedure in patients with keratoconus. METHODS: A total of 22 keratoconus patient's candidate for CCL procedures were included based on specific criteria, with meticulous exclusion criteria in place to minimize potential confounders. Participants underwent OCTA assessments of the ONH and macula using the Spectralis OCT (Heidelberg) before CCL, as well as at 1- and 3-months post-CCL. MATLAB software was utilized for image analysis. RESULTS: The mean age of the participants was 20.09 ± 6.11, including 59% male, and the mean intraocular pressure (IOP) before the surgery was 13.59 ± 2.85 mmHg. Peripapillary Retinal nerve fiber layer (ppRNFL) thickness and overall retinal thickness remained stable post-CCL. However, significant alterations were observed in macular vessel density, emphasizing regional variations in vascular response. For macular large vessel density (LVD), both superficial and deep vascular complex (SVC and DVC) demonstrated significant differences between before surgery and the 3 months post-surgery follow-up (p < 0.001 and p = 0.002, respectively). Optic nerve head markers demonstrated relative stability, except for changes in avascular complex density, which was 49.2 ± 2.2% before the surgery and decrease to 47.6 ± 1.7% three months after the operation (P-value = 0.005). CONCLUSION: While CCL appears to maintain the integrity of certain ocular structures, alterations in macular perfusion post-CCL suggest potential effects on retinal blood supply. Long-term monitoring is crucial to understand the implications of these changes, particularly in the context of conditions such as diabetes.


Assuntos
Colágeno , Reagentes de Ligações Cruzadas , Angiofluoresceinografia , Ceratocone , Disco Óptico , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Ceratocone/fisiopatologia , Ceratocone/diagnóstico , Masculino , Feminino , Colágeno/metabolismo , Adulto Jovem , Adulto , Angiofluoresceinografia/métodos , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/fisiopatologia , Disco Óptico/irrigação sanguínea , Adolescente , Estudos Prospectivos , Fármacos Fotossensibilizantes/uso terapêutico , Fotoquimioterapia/métodos , Macula Lutea/diagnóstico por imagem , Macula Lutea/irrigação sanguínea
8.
Diabetes Metab Res Rev ; 40(4): e3812, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38738481

RESUMO

AIMS: To evaluate the effectiveness of optical coherence tomography angiography (OCTA) in detecting early intraocular microvascular changes in diabetic patients. MATERIALS AND METHODS: A systematic study search was performed on PubMed, Medline, Embase, and the Cochrane Library, ranging from January 2012 to March 2023. Controlled studies compared diabetes mellitus (DM) patients with non-diabetic retinopathy (NDR) or patients with mild non-proliferative diabetic retinopathy (mild NPDR) to healthy people. These studies included parameters of OCTA such as foveal avascular zone (FAZ), vessel density of superficial capillary plexus (VDscp), vessel density of deep capillary plexus (VDdcp), and peripapillary VD. The relevant effect model was used according to the heterogeneity, and the mean difference and 95% confidence intervals were calculated. RESULTS: A total of 18 studies with 2101 eyes were eventually included in this meta-analysis. Our results demonstrated that early alterations of VDscp, VDdcp, and peripapillary VD in NDR patients had a significant difference compared with healthy people by OCTA (VDscp: WMD = -1.34, 95% CI: -1.99 to -0.68, P < 0.0001. VDdcp: WMD = -2.00, 95% CI: -2.95 to -1.04, P < 0.0001. Peripapillary VD: WMD = -1.07, 95% CI: -1.70 to -0.43, P = 0.0010). However, there was no statistically significant difference in total FAZ between them (WMD = -0.00, 95% CI: -0.02-0.01, P = 0.84). In addition, for patients with mild NPDR, OCTA could illustrate prominent changes in VDscp, VDdcp, and total FAZ compared with healthy people (VDscp: WMD = -6.11, 95% CI: -9.90 to -2.32, P = 0.002. VDdcp: WMD = -4.26, 95% CI: -5.95 to -2.57, P < 0.00001. FAZ: WMD = 0.06, 95% CI: 0.01-0.11, P = 0.03). CONCLUSIONS: In diabetic patients with or without retinopathy, the parameters of OCTA such as VDscp, VDdcp, and peripapillary vessel density were demonstrated as potential biomarkers in monitoring the early alterations of retinal microangiopathy, while total FAZ may have no significant changes in diabetic patients without retinopathy.


Assuntos
Retinopatia Diabética , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Retinopatia Diabética/diagnóstico por imagem , Retinopatia Diabética/etiologia , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Angiofluoresceinografia/métodos , Microvasos/diagnóstico por imagem , Microvasos/patologia , Diabetes Mellitus/diagnóstico por imagem , Prognóstico
9.
J Am Heart Assoc ; 13(9): e033081, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38639343

RESUMO

BACKGROUND: Retinal ischemic perivascular lesions (RIPLs) are an indicator of ischemia in the middle retina. We aimed to determine the relationship between RIPLs and single subcortical infarction (SSI). We also investigated the differences in cerebral small vessel disease imaging burden between groups with and without RIPLs in SSI. METHODS AND RESULTS: In this case-control study, we enrolled 82 patients with SSI and 72 nonstroke controls. All participants underwent magnetic resonance imaging and swept-source optical coherence tomography/optical coherence tomography angiography. Small vessel disease markers such as lacunes, cerebral microbleeds, white matter hyperintensity, and perivascular spaces were rated on brain imaging. RIPLs were assessed via swept-source optical coherence tomography. Optical coherence tomography angiography was used to measure the superficial vascular complex and deep vascular complex of the retina. After adjusting for risk factors, the presence of RIPLs was significantly associated with SSI (odds ratio [OR], 1.506 [95% CI, 1.365-1.662], P<0.001). Eyes with RIPLs showed lower deep vascular complex density (P=0.035) compared with eyes without RIPLs in patients with SSI. After adjusting for vascular risk factors, the presence of RIPLs in patients with SSI was associated with an increased periventricular white matter hyperintensity burden (ß=0.414 [95% CI, 0.181-0.647], P<0.001) and perivascular spaces-basal ganglia (ß=0.296 [95% CI, 0.079-0.512], P=0.008). CONCLUSIONS: RIPLs are associated with SSI independent of underlying risk factors. The relationship between the presence of RIPLs and small vessel disease markers provides evidence that RIPLs might be an additional indicator of cerebral ischemic changes.


Assuntos
Doenças de Pequenos Vasos Cerebrais , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Masculino , Feminino , Tomografia de Coerência Óptica/métodos , Idoso , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Doenças de Pequenos Vasos Cerebrais/complicações , Pessoa de Meia-Idade , Estudos de Casos e Controles , Vasos Retinianos/patologia , Vasos Retinianos/diagnóstico por imagem , Imageamento por Ressonância Magnética , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Infarto Cerebral/diagnóstico por imagem , Fatores de Risco
10.
Opt Lett ; 49(8): 2121-2124, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38621091

RESUMO

The purpose of this study is to verify the effect of anisotropic property of retinal biomechanics on vasodilation measurement. A custom-built optical coherence tomography (OCT) was used for time-lapse imaging of flicker stimulation-evoked vessel lumen changes in mouse retinas. A comparative analysis revealed significantly larger (18.21%) lumen dilation in the axial direction compared to the lateral (10.77%) direction. The axial lumen dilation predominantly resulted from the top vessel wall movement toward the vitreous direction, whereas the bottom vessel wall remained stable. This observation indicates that the traditional vasodilation measurement in the lateral direction may result in an underestimated value.


Assuntos
Tomografia de Coerência Óptica , Vasodilatação , Animais , Camundongos , Vasodilatação/fisiologia , Tomografia de Coerência Óptica/métodos , Estimulação Luminosa/métodos , Retina/diagnóstico por imagem , Retina/fisiologia , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/fisiologia
11.
Physiol Meas ; 45(5)2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38599224

RESUMO

Objective.This study aims to automate the segmentation of retinal arterioles and venules (A/V) from digital fundus images (DFI), as changes in the spatial distribution of retinal microvasculature are indicative of cardiovascular diseases, positioning the eyes as windows to cardiovascular health.Approach.We utilized active learning to create a new DFI dataset with 240 crowd-sourced manual A/V segmentations performed by 15 medical students and reviewed by an ophthalmologist. We then developed LUNet, a novel deep learning architecture optimized for high-resolution A/V segmentation. The LUNet model features a double dilated convolutional block to widen the receptive field and reduce parameter count, alongside a high-resolution tail to refine segmentation details. A custom loss function was designed to prioritize the continuity of blood vessel segmentation.Main Results.LUNet significantly outperformed three benchmark A/V segmentation algorithms both on a local test set and on four external test sets that simulated variations in ethnicity, comorbidities and annotators.Significance.The release of the new datasets and the LUNet model (www.aimlab-technion.com/lirot-ai) provides a valuable resource for the advancement of retinal microvasculature analysis. The improvements in A/V segmentation accuracy highlight LUNet's potential as a robust tool for diagnosing and understanding cardiovascular diseases through retinal imaging.


Assuntos
Aprendizado Profundo , Fundo de Olho , Processamento de Imagem Assistida por Computador , Humanos , Vênulas/diagnóstico por imagem , Vênulas/anatomia & histologia , Processamento de Imagem Assistida por Computador/métodos , Arteríolas/diagnóstico por imagem , Arteríolas/anatomia & histologia , Vasos Retinianos/diagnóstico por imagem
12.
Klin Monbl Augenheilkd ; 241(4): 562-570, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38653313

RESUMO

PURPOSE: Proof of concept of ex vivo retinal vessel diameter measurements in human postmortem eyes. METHODS: En face near-infrared (IR) images and optical coherence tomography (OCT) of the optic nerve head (ONH) were captured ex vivo with a Heidelberg Engineering Spectralis (Spectralis, version 7.0.4, Image Capture Module, version 1.2.4, Heidelberg Heidelberg, Germany) device, using a custom-made eye chamber holding and positioning the eyes during the image process. Thirty-two formaldehyde-fixated eyes of 16 patients were imaged. In the IR images, two independent graders measured retinal vessel diameters at the intersection of a drawn circle centered on the ONH with diameters of 2.0 mm and 3.4 mm, respectively. The anatomically corresponding measurements between both graders were statistically analyzed using a Wilcoxon signed-rank test. RESULTS: A total of 246 matched measurements of both graders were analyzed across all 32 imaged eyes. Statistically significant differences between the graders were found for arterioles at 2 mm from the ONH. The other measurements did not show statistically significant intergrader differences. The mean values for arteriole diameters were 72.2 µm at 2.0 mm and 61.5 µm at 3.4 mm for grader 1, and 66.4 µm at 2.0 mm and 63.2 µm at 3.4 mm for grader 2. The mean diameter for venules were 75.5 µm at 2.0 mm and 79.3 µm at 3.4 mm for grader 1, and 67.4 µm at 2 mm and 79.1 µm at 3.4 mm for grader 2. CONCLUSION: To the best of our knowledge, this is the first study to present IR image-based retinal vessel diameters in ex vivo postmortem eyes. Retinal IR/OCT imaging is possible, and measurements are reproducible in formaldehyde-fixated human eyes. Fixation artefacts result in lower image quality, and this can impose challenges in correctly detecting, classifying, and measuring retinal vessels.


Assuntos
Disco Óptico , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia , Feminino , Masculino , Disco Óptico/diagnóstico por imagem , Disco Óptico/irrigação sanguínea , Disco Óptico/patologia , Idoso , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Idoso de 80 Anos ou mais , Autopsia/métodos , Cadáver
13.
Sci Rep ; 14(1): 9092, 2024 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-38643302

RESUMO

Vascular and neural structures of the retina can be visualized non-invasively and used to predict ocular and systemic pathologies. We set out to evaluate the association of hemoglobin (Hb) levels within the national reference interval with retinal vascular caliber, optical coherence tomography (OCT) and visual field (VF) parameters in the Northern Finland 1966 Birth Cohort (n = 2319, 42.1% male, average age 47 years). The studied parameters were evaluated in Hb quintiles and multivariable linear regression models. The lowest Hb quintile of both sexes presented the narrowest central retinal vein equivalent (CRVE) and the healthiest cardiometabolic profile compared to the other Hb quintiles. In the regression models, CRVE associated positively with Hb levels in both sexes, (Bmales = 0.068 [0.001; 0.135], Bfemales = 0.087 [0.033; 0.140]), after being adjusted for key cardiometabolic and inflammatory parameters, smoking status, and fellow vessel caliber. No statistically significant associations of Hb levels with central retinal artery equivalent, OCT or VF parameters were detected. In conclusion, Hb levels were positively and specifically associated with CRVE, indicating that Hb levels are an independent factor affecting CRVE and the effect is in parallel with established risk factors for cardiometabolic diseases.


Assuntos
Doenças Cardiovasculares , Oftalmopatias , Pessoa de Meia-Idade , Feminino , Humanos , Masculino , Coorte de Nascimento , Oftalmopatias/patologia , Retina/diagnóstico por imagem , Doenças Cardiovasculares/patologia , Hemoglobinas , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia
14.
Chem Biol Interact ; 394: 110996, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38593908

RESUMO

Diabetic retinopathy is not cured efficiently and changes of lifestyle measures may delay early retinal injury in diabetes. The aim of our study was to investigate the effects of reduced daily light exposure on retinal vascular changes in streptozotocin (STZ)-induced model of DM with emphasis on inflammation, Aqp4 expression, visual cycle and cholesterol metabolism-related gene expression in rat retina and RPE. Male Wistar rats were divided into the following groups: 1. control; 2. diabetic group (DM) treated with streptozotocin (100 mg/kg); 3. group exposed to light/dark cycle 6/18 h (6/18); 4. diabetic group exposed to light/dark cycle 6/18 h (DM+6/18). Retinal vascular abnormalities were estimated based on lectin staining, while the expression of genes involved in the visual cycle, cholesterol metabolism, and inflammation was determined by qRT-PCR. Reduced light exposure alleviated vasculopathy, gliosis and the expression of IL-1 and TNF-α in the retina with increased perivascular Aqp4 expression. The expression of genes involved in visual cycle and cholesterol metabolism was significantly up-regulated in RPE in DM+6/18 vs. DM group. In the retina only the expression of APOE was significantly higher in DM+6/18 vs. DM group. Reduced light exposure mitigates vascular changes and gliosis in DM via its anti-inflammatory effect, increased retinal cholesterol turnover and perivascular Aqp4 expression.


Assuntos
Colesterol , Diabetes Mellitus Experimental , Retinopatia Diabética , Gliose , Luz , Ratos Wistar , Retina , Estreptozocina , Animais , Masculino , Retinopatia Diabética/metabolismo , Retinopatia Diabética/patologia , Retina/metabolismo , Retina/patologia , Retina/efeitos da radiação , Colesterol/metabolismo , Ratos , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/complicações , Gliose/patologia , Gliose/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Fator de Necrose Tumoral alfa/genética , Anti-Inflamatórios/farmacologia , Aquaporina 4/metabolismo , Aquaporina 4/genética , Vasos Retinianos/metabolismo , Vasos Retinianos/patologia
15.
Comput Biol Med ; 174: 108443, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38608328

RESUMO

Retinal vessel segmentation based on deep learning is an important auxiliary method for assisting clinical doctors in diagnosing retinal diseases. However, existing methods often produce mis-segmentation when dealing with low contrast images and thin blood vessels, which affects the continuity and integrity of the vessel skeleton. In addition, existing deep learning methods tend to lose a lot of detailed information during training, which affects the accuracy of segmentation. To address these issues, we propose a novel dual-decoder based Cross-patch Feature Interactive Net with Edge Refinement (CFI-Net) for end-to-end retinal vessel segmentation. In the encoder part, a joint refinement down-sampling method (JRDM) is proposed to compress feature information in the process of reducing image size, so as to reduce the loss of thin vessels and vessel edge information during the encoding process. In the decoder part, we adopt a dual-path model based on edge detection, and propose a Cross-patch Interactive Attention Mechanism (CIAM) in the main path to enhancing multi-scale spatial channel features and transferring cross-spatial information. Consequently, it improve the network's ability to segment complete and continuous vessel skeletons, reducing vessel segmentation fractures. Finally, the Adaptive Spatial Context Guide Method (ASCGM) is proposed to fuse the prediction results of the two decoder paths, which enhances segmentation details while removing part of the background noise. We evaluated our model on two retinal image datasets and one coronary angiography dataset, achieving outstanding performance in segmentation comprehensive assessment metrics such as AUC and CAL. The experimental results showed that the proposed CFI-Net has superior segmentation performance compared with other existing methods, especially for thin vessels and vessel edges. The code is available at https://github.com/kita0420/CFI-Net.


Assuntos
Aprendizado Profundo , Vasos Retinianos , Vasos Retinianos/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Algoritmos
16.
Sci Rep ; 14(1): 8395, 2024 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-38600099

RESUMO

The aim of the present study was to investigate retinal microcirculatory and functional metabolic changes in patients after they had recovered from a moderate to severe acute COVID-19 infection. Retinal perfusion was quantified using laser speckle flowgraphy. Oxygen saturation and retinal calibers were assessed with a dynamic vessel analyzer. Arterio-venous ratio (AVR) was calculated based on retinal vessel diameter data. Blood plasma samples underwent mass spectrometry-based multi-omics profiling, including proteomics, metabolomics and eicosadomics. A total of 40 subjects were included in the present study, of which 29 had recovered from moderate to severe COVID-19 within 2 to 23 weeks before inclusion and 11 had never had COVID-19, as confirmed by antibody testing. Perfusion in retinal vessels was significantly lower in patients (60.6 ± 16.0 a.u.) than in control subjects (76.2 ± 12.1 a.u., p = 0.006). Arterio-venous (AV) difference in oxygen saturation and AVR was significantly lower in patients compared to healthy controls (p = 0.021 for AVR and p = 0.023 for AV difference in oxygen saturation). Molecular profiles demonstrated down-regulation of cell adhesion molecules, NOTCH3 and fatty acids, and suggested a bisphasic dysregulation of nitric oxide synthesis after COVID-19 infection. The results of this study imply that retinal perfusion and oxygen metabolism is still significantly altered in patients well beyond the acute phase of COVID-19. This is also reflected in the molecular profiling analysis of blood plasma, indicating a down-regulation of nitric oxide-related endothelial and immunological cell functions.Trial Registration: ClinicalTrials.gov ( https://clinicaltrials.gov ) NCT05650905.


Assuntos
COVID-19 , Oxigênio , Humanos , Oxigênio/metabolismo , Microcirculação , Óxido Nítrico , Oximetria/métodos , Vasos Retinianos , Perfusão , Proteínas Sanguíneas , Lipídeos
17.
Opt Express ; 32(6): 10329-10347, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38571248

RESUMO

Optical coherence tomography (OCT) and its extension OCT angiography (OCTA) have become essential clinical imaging modalities due to their ability to provide depth-resolved angiographic and tissue structural information non-invasively and at high resolution. Within a field of view, the anatomic detail available is sufficient to identify several structural and vascular pathologies that are clinically relevant for multiple prevalent blinding diseases, including age-related macular degeneration (AMD), diabetic retinopathy (DR), and vein occlusions. The main limitation in contemporary OCT devices is that this field of view is limited due to a fundamental trade-off between system resolution/sensitivity, sampling density, and imaging window dimensions. Here, we describe a swept-source OCT device that can capture up to a 12 × 23-mm field of view in a single shot and show that it can identify conventional pathologic features such as non-perfusion areas outside of conventional fields of view. We also show that our approach maintains sensitivity sufficient to visualize novel features, including choriocapillaris morphology beneath the macula and macrophage-like cells at the inner limiting membrane, both of which may have implications for disease.


Assuntos
Retinopatia Diabética , Vasos Retinianos , Humanos , Vasos Retinianos/patologia , Angiofluoresceinografia , Tomografia de Coerência Óptica/métodos , Retina
18.
Int Ophthalmol ; 44(1): 178, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38622472

RESUMO

PURPOSE: To determine the microvascular and structural changes in the peripapillary and macular areas observed in patients with active thyroid orbitopathy(TO) before and after steroid treatment and compare with inactive TO and the control group by optical coherence tomography angiography (OCTA). MATERIAL AND METHOD: This cross-sectional study included 34 eyes of 17 active TO patients, 108 eyes of 54 inactive TO patients, and 60 eyes of 30 healthy controls. Central macular thickness (CMT), ganglion cell layer-inner plexiform layer (GCL-IPL) thickness, central choroidal thickness (CCT), retinal nerve fiber layer (RNFL) thickness, choroidal thickness in the peripapillary region, superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris vessel densities were determined by OCTA in before and after 12-week steroid treatment of active TO cases, inactive TO and control groups. RESULTS: Between the three groups in macula OCTA, a statistically significant difference was observed in the inferior and nasal quadrants in SCP (all p = 0.01) and only in the temporal quadrant choriocapillaris (p = 0.005). In peripapillary OCTA, a statistically significant difference was found only in the central choriocapillaris (p = 0.03). In the comparison of the active group before and after treatment, there was a statistically significant decrease in CMT and CCT; a statistically significant increase was observed in GCL-IPL (all p < 0.01). There was a statistically significant decrease in SCP and DCP only in the central (all p < 0.01). There was a statistically significant increase was found in the lower quadrant macular SCP vessel density and mean macular DCP in post-treatment measurements (p = 0.01 and p = 0.03, respectively). Peripapillary SCP and DCP vessel density was increased after treatment (p < 0.01). CONCLUSION: Active TO group had lower vessel density than inactive group and after treatment, vessel density was increased. Non-invasive quantitative analysis of retinal and optic disc perfusion using OCTA could be useful in early treatment before complications occur and monitoring patients with TO.


Assuntos
Oftalmopatia de Graves , Disco Óptico , Humanos , Angiofluoresceinografia/métodos , Vasos Retinianos , Tomografia de Coerência Óptica/métodos , Oftalmopatia de Graves/diagnóstico , Oftalmopatia de Graves/tratamento farmacológico , Estudos Transversais , Esteroides
19.
Artigo em Inglês | MEDLINE | ID: mdl-38673350

RESUMO

Our aim was to investigate the impact of shiftwork on changes in central retinal arteriolar equivalent (CRAE), a measure of arteriolar width, and central retinal venular equivalent (CRVE), a measure of venular width, over five years. The participants were 117 officers (72.7% men) examined at the first (2011-2014) and second (2015-2019) follow-up examinations in the Buffalo Cardio-Metabolic Occupational Police Stress study. Shiftwork data were obtained from the City of Buffalo, NY payroll records. Retinal diameters were measured using a standardized protocol. ANCOVA was used to compare mean change in CRAE and CRVE between the two examinations across shiftwork categories. Among men only, those who worked ≥70% hours on day shifts had a larger decrease in mean CRAE (-7.13 µm ± 2.51) compared to those who worked <70% day (-0.08 ± 0.96; p = 0.011). Among patrol officers, those who worked ≥70% day had a larger decrease in CRAE compared to those who worked <70% day (p = 0.015). Also, officers who worked ≥70% day had an increase in mean CRVE (µm) (4.56 ± 2.56) compared to those who worked <70% (-2.32 ± 1.32; p = 0.027). Over the five-year period, we observed adverse changes in arteriolar and venular diameters among officers who worked ≥70% on day shifts. The results should be interpreted with caution due to the small sample sizes.


Assuntos
Vasos Retinianos , Humanos , Masculino , Vasos Retinianos/anatomia & histologia , Feminino , Adulto , Pessoa de Meia-Idade , Jornada de Trabalho em Turnos , Polícia , New York
20.
Optom Vis Sci ; 101(4): 224-231, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38684065

RESUMO

PURPOSE: This study aimed to demonstrate that the pattern and degree of capillary bed dropout in early glaucoma appear different on OCT-A superficial plexus en-face slabs compared with retinal ischemia. RNFL loss associated with retinal ischemia in diabetic patients may be explained and accounted for by overlying the RNFL deviation map on a superficial plexus en-face montage. CASE REPORTS: Three middle-aged White men with diabetes mellitus showed cup-to-disc ratios of approximately 0.7 and RNFL and ganglion thinning. Each patient had several Cirrus OCT and OCT-A scans taken of the posterior pole. The OCT-A en-face images demonstrated specific patterns of superficial capillary dropout. The appearance of superficial plexus capillary dropout in one case of glaucoma is contrasted against two cases of retinal ischemia. CONCLUSIONS: Early glaucoma appears to be associated with incomplete capillary bed dropout that extends from macular regions to the disc in a wedge- or arc-shaped pattern. Diabetic retinal ischemia appears to be associated with well-defined patchy and polygonal pockets of complete capillary bed obliteration that may not extend back to the disc. If an RNFL deviation map is superimposed over the superficial plexus en-face montage, areas of RNFL loss may correlate with and thus be well accounted for by areas of retinal ischemia in cases with RNFL thinning likely from ischemia. This approach may supplement inspection of OCT B-scans for focal retinal thinning when trying to differentiate RNFL and ganglion cell loss from retinal ischemia versus glaucoma in patients with diabetes. Formal research studies are needed to validate our observations and proposed use of OCT-A together with OCT in these patients.


Assuntos
Retinopatia Diabética , Isquemia , Fibras Nervosas , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Humanos , Masculino , Tomografia de Coerência Óptica/métodos , Pessoa de Meia-Idade , Isquemia/diagnóstico , Retinopatia Diabética/diagnóstico , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Vasos Retinianos/patologia , Vasos Retinianos/diagnóstico por imagem , Glaucoma/diagnóstico , Glaucoma/fisiopatologia , Diagnóstico Diferencial
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