Longitudinal Evaluation of Microvascular Changes and Imaging Biomarkers Associated with Visual Prognosis in Retinal Artery Occlusion.

IF 4.2 1区 医学 Q1 OPHTHALMOLOGY
Chong Chen,Kayla Nicole Nodecker,Rajiv M Sastry,Leiyu Wang,Xinyi Ding,Ying Zhu,Francesco Romano,Filippos Vingopoulos,Robbert Roel Struyven,Ioanna Ploumi,Selin S Gumustop,Shivesh Himanshu Shah,Sarah Lillian Wagner,Nimesh A Patel,Leo A Kim,David M Wu,Demetrios Vavvas,Deeba Husain,Joan W Miller,John B Miller
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引用次数: 0

Abstract

PURPOSE To longitudinally assess changes in macular thickness and microvascular metrics in retinal artery occlusion (RAO) patients, and to identify imaging biomarkers associated with visual prognosis. DESIGN Retrospective cohort study. PARTICIPANTS 56 RAO patients (57 eyes) and 27 controls (30 eyes). METHODS Comprehensive ophthalmic evaluations were performed, including macular OCT and 6 × 6 mm swept-source OCT angiography (SS-OCTA). Retinal thickness, macular ischemic area, ischemia-fovea distance, vessel skeletonized density (VSD), vessel density (VD), and foveal avascular zone (FAZ) area were quantified. Receiver operating characteristic (ROC) and linear regression analyses assessed imaging biomarkers correlated with visual outcomes. MAIN OUTCOME MEASURES Longitudinal changes in retinal structure and microvasculature, and their associations with final visual acuity (VA). RESULTS Among 57 RAO eyes (28 BRAO) with a median follow-up of 83.0 (35.5, 172.0) weeks, retinal thickness significantly decreased over time (p < 0.05), while macular ischemic area expanded from 64.97% to 73.58% (p = 0.002). In a subset of 24 RAO eyes with longitudinal SS-OCTA scans, eyes with a baseline ischemic area ≤ 1/3 of the scan area showed increased VSD and VD in both plexuses over time (p < 0.05). FAZ area was significantly larger in CRAO compared to BRAO (p = 0.0001), although no statistically significant change in FAZ area was observed over time (p = 0.341), a numerical increase was noted in CRAO cases. Better baseline VA, greater ischemic distance to fovea, smaller initial ischemic area, higher VSD and VD in SCP, and smaller FAZ area were associated with better final VA (all p < 0.05, AUC: 0.80-0.89). Multivariable linear regression identified baseline ischemic area and FAZ area as independent predictors of final VA (p = 0.003, 0.008). CONCLUSIONS Multimodal quantification demonstrates the progressive ischemia in RAO and potential reperfusion in eyes with limited involvement. Ischemic area and FAZ area are key imaging biomarkers for visual prognosis.
视网膜动脉闭塞与视力预后相关的微血管变化和成像生物标志物的纵向评价。
目的纵向评估视网膜动脉闭塞(RAO)患者黄斑厚度和微血管指标的变化,并确定与视力预后相关的成像生物标志物。设计回顾性队列研究。参与者:56例RAO患者(57眼)和27例对照(30眼)。方法采用黄斑OCT和6 × 6 mm扫源OCT血管造影(SS-OCTA)进行综合眼科检查。量化视网膜厚度、黄斑缺血面积、缺血-中央凹距离、血管骨化密度(VSD)、血管密度(VD)、中央凹无血管带(FAZ)面积。受试者工作特征(ROC)和线性回归分析评估了与视觉结果相关的成像生物标志物。主要观察指标:视网膜结构和微血管的纵向变化及其与最终视力(VA)的关系。结果57只RAO眼(28只BRAO)中位随访时间为83.0(35.5,172.0)周,视网膜厚度随时间的推移显著降低(p < 0.05),黄斑缺血面积从64.97%扩大到73.58% (p = 0.002)。在24只RAO眼的纵向SS-OCTA扫描中,基线缺血区域≤1/3的眼睛随着时间的推移,双神经丛VSD和VD增加(p < 0.05)。CRAO的FAZ面积明显大于BRAO (p = 0.0001),尽管FAZ面积随时间的变化没有统计学意义(p = 0.341),但CRAO病例的FAZ面积明显增加。基线VA越好、缺血距中央凹越远、初始缺血面积越小、SCP的VSD和VD越高、FAZ面积越小与最终VA越好相关(p < 0.05, AUC: 0.80-0.89)。多变量线性回归发现基线缺血面积和FAZ面积是最终VA的独立预测因子(p = 0.003,0.008)。结论多模态定量显示了视网膜下视网膜的进行性缺血和有限受累眼的潜在再灌注。缺血区和FAZ区是视觉预后的重要影像生物标志物。
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来源期刊
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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