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Macular grids and sectors. Macular (8.1-mm square) 10 × 10 grids were stratified into eight sectors according to the quadrant and the eccentricity from the fovea. The left eye was mirror imaged.
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Purpose:
We recently reported on the usefulness of retinal artery trajectory in estimating the magnitude of retinal stretch due to myopia. The purpose of the present study was to elucidate the relationship between the peripapillary retinal artery angle (PRAA) and thickness of the macular ganglion cell-inner plexiform layer (GCIPL).
Methods:
This...
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... the boundaries were checked, and eyes with segmentation errors were carefully excluded from the study. All 65,536 (128 × 512) A-scan pixels of GCIPL thickness were exported for each eye, and those in the analysis area were divided into 10 × 10 grids, then stratified into eight sectors according to the quadrant and the eccentricity from the fovea (Fig. 1). The data obtained in the left eye were mirror-imaged to those obtained in the right eye for statistical ...
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Background:
Hypertensive glaucoma (HTG) causes damage to the retinal ganglion cells and eventually to the entire visual pathway due to high intraocular pressure (IOP). However, increased IOP will also affect the vessel density (VD) of the posterior pole of the eye and the related retinal ganglion nerve fibres (RNFL). In normotensive glaucoma (NTG)...
Citations
... Previous studies have variably reported reduced GCL thickness with increasing myopia and no effect with refractive error (Mwanza et al., 2011;Omoto et al., 2020;Sezgin Akcay et al., 2017;Tong et al., 2020), and a single study investigating the INL reported significant reductions in high myopia (Kim et al., 2020). The apparent reduction with increasing myopia may be related to transverse magnification effects rather than indicative of "true" reductions in retinal thickness with myopia (Lal et al., 2021;Lee et al., 2021;Omoto et al., 2020). ...
... Previous studies have variably reported reduced GCL thickness with increasing myopia and no effect with refractive error (Mwanza et al., 2011;Omoto et al., 2020;Sezgin Akcay et al., 2017;Tong et al., 2020), and a single study investigating the INL reported significant reductions in high myopia (Kim et al., 2020). The apparent reduction with increasing myopia may be related to transverse magnification effects rather than indicative of "true" reductions in retinal thickness with myopia (Lal et al., 2021;Lee et al., 2021;Omoto et al., 2020). As this study applied relatively constrained refractive error criteria, corrections for transverse magnification may be more pertinent for highly myopic eyes. ...
This study sought to identify demographic variations in retinal thickness measurements from optical coherence tomography (OCT), to enable the calculation of cell density parameters across the neural layers of the healthy human macula. From macular OCTs (n = 247), ganglion cell (GCL), inner nuclear (INL), and inner segment-outer segment (ISOS) layer measurements were extracted using a customized high-density grid. Variations with age, sex, ethnicity, and refractive error were assessed with multiple linear regression analyses, with age-related distributions further assessed using hierarchical cluster analysis and regression models. Models were tested on a naïve healthy cohort (n = 40) with Mann-Whitney tests to determine generalizability. Quantitative cell density data were calculated from histological data from previous human studies. Eccentricity-dependent variations in OCT retinal thickness closely resemble topographic cell density maps from human histological studies. Age was consistently identified as significantly impacting retinal thickness (p = .0006, .0007, and .003 for GCL, INL and ISOS), with gender affecting ISOS only (p < .0001). Regression models demonstrated that age-related changes in the GCL and INL begin in the 30th decade and were linear for the ISOS. Model testing revealed significant differences in INL and ISOS thickness (p = .0008 and .0001; however, differences fell within the OCT's axial resolution. Qualitative comparisons show close alignment between OCT and histological cell densities when using unique, high-resolution OCT data, and correction for demographics-related variability. Overall, this study describes a process to calculate in vivo cell density from OCT for all neural layers of the human retina, providing a framework for basic science and clinical investigations.
... quadrants, we found a statistically significant, strong negative connection between the axial length and GCL thickness (P-value 0.05). Similar studies conducted by Song et al., [23] Seo et al., [17] and Omoto et al. [24] have shown that the mean macular thickness was negatively correlated with the axial length, but it may vary in different regions. ...
Purpose:
To analyze the correlation between the mean retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness with axial length and refractive errors among children aged 5-15 years.
Methods:
This cross-sectional, observational study was done on 130 eyes of 65 consecutive subjects with refractive errors. The patients were evaluated for RNFL thickness and macular GCL thickness using spectral domain- optical coherence tomography.
Results:
One hundred and thirty eyes of 65 subjects aged between 5 and 15 years were divided into three groups based on their spherical equivalent in diopters (D). The children with a spherical equivalent of ≤-0.50 D were considered myopic, ≥-0.5 to ≤+0.5 D were considered emmetropic, and ≥+0.50 D were considered hypermetropic. RNFL thickness and GCL thickness were correlated with age, gender, spherical equivalent, and axial length. The mean global RNFL thickness was 104.58 μm ± 7.567.
Conclusion:
There exists a negative correlation between RNFL thickness and macular GCL thickness with increasing severity of myopia and increase in axial length, and the possible reason could be stretching of the sclera, which further leads to stretching of the retina, resulting in thinner RNFL and macular GCL thickness.
... 16 Supporting this, we have recently shown that the macular ganglion cell-inner plexiform layer (GCIPL) thickness becomes thin when the major retinal artery angle is narrow, even after adjustment for AL. 17 The purpose of the current study was to investigate the importance of retinal parameters, including positions of the optic disc and major retinal arteries, on VF progression in POAG patients. As results are expected to differ across VF sectors (according to the corresponding location of the optic disc), analyses were conducted by dividing the VF into small sectors using a previously reported mapping between the VF and optic disc. ...
... We recently reported that the retina is stretched, and the macular GCIPL becomes thin, when the major retinal artery angle is narrow, even after adjustment for AL. 17 The reason for this association and the importance on the progression of glaucoma is still to be elucidated, however, as we now observe a narrow superior retinal artery angle may be associated with faster VF progression in VF sectors 1 and 2. In contrast, the opposite tendency was observed between the position of the inferior retinal artery and VF progression rate in sector 5. The result appears contradictory, but we postulate that this area of the VF is affected by the superior eye lid and an accurate assessment of VF damage is difficult. ...
Purpose:
To investigate whether retinal structural parameters, including positions of the optic disc and major retinal arteries, affect glaucomatous progression of the visual field (VF).
Methods:
In this cohort study, 116 eyes of 73 patients with primary open angle glaucoma (POAG) were included. VFs were measured using the Humphrey Field Analyzer 24-2 program and the VF was divided into seven sectors according to the corresponding optic disc angle. Average total deviation (TD) was calculated in each sector. Positions of major retinal arteries in the superotemporal and inferotemporal areas were decided by identifying the points where the retinal artery intersected the 3.4-mm-diameter circle around the optic disc. The relationship between sectorial TD VF progression rate and eight variables (age, mean and standard deviation of intraocular pressure during the observation period, baseline sectorial TD value, papillomacular bundle tilt angle, and axial length, along with superior/inferior arterial angle) was investigated.
Results:
The main outcome measures were the association between retinal structural parameters and glaucomatous progression of VF. The superior retinal artery angular position was positively associated with sectorial TD progression rates in two central sectors in the inferior hemifield, which suggests faster VF progression where superior retinal artery angles are narrow. Papillomacular bundle tilt was not associated with TD progression rate in any sector.
Conclusions:
Progression of the inferior VF was associated with the superior retinal artery angular position in this study of POAG.
... Fitting with that notion, a higher prevalence of myopic maculopathy and longer axial length was associated with a thinner peripapillary retinal nerve fiber layer in the recent Ural Eye and Medical Study, after adjusting for the prevalence and amount of glaucomatous optic neuropathy or after excluding eyes with glaucomatous optic neuropathy from the statistical analysis 28 . In a parallel manner, Omoto and colleagues reported that in 138 healthy eyes without any known eye disease the macular ganglion cell-inner plexiform layer thickness decreased significantly with narrowing of the peripapillary retinal artery angle (or angle kappa) 29 www.nature.com/scientificreports/ Narrowing of the angle kappa was strongly correlated with an elongation of the DFD. ...
To assess changes in the disc-fovea distance (DFD) in highly myopic eyes in a 10-year population-based follow-up study. The case control study included all highly myopic eyes (myopic refractive error ≥ − 6.0 diopters or axial length ≥ 26.0 mm) and a randomized group of non-highly myopic eyes examined in the population-based Beijing Eye Study 2001 and 2011. Using fundus photographs and optical coherence tomographic images, we assessed changes in DFD, parapapillary gamma zone, angle kappa (angle between the temporal arterial arcades), and course of papillo-macular retinal vessels. The study included 89 highly myopic eyes and 86 non-highly myopic eyes. DFD elongation, gamma zone widening, angle kappa decrease and straightening of papillo-macular retinal vessels were detected more often (all P < 0.001) in the highly myopic group than in the non-highly myopic group (63/89 versus 9/86;75/89 versus 18/86;61/89 versus 9/86; and 58/89 versus 7/86,respectively). Gamma zone enlargement, angle kappa reduction and papillo-macular retinal vessel straightening were significantly (all P < 0.001) associated with DFD elongation. The length of macular Bruch’s membrane on the disc-fovea line and the vertical distance between the temporal arterial arcade did not change during follow-up. DFD elongation (10-year incidence 70.8% in highly myopic eyes) was associated with gamma zone enlargement, while macular Bruch’s membrane length remained unchanged. It supports the notion of a temporal shift of an otherwise stable posterior Bruch’s membrane in axially elongated eyes. Straightening of the papillo-macular vessels with increasing gamma zone width suggests a coincident stretching of the papillo-macular retinal nerve fibers and inner limiting membrane.
Purpose:
To evaluate the retinal artery angles in high axial myopia and assess the correlation with other morphometric and functional parameters.
Methods:
This cross-sectional study included 112 eyes of 112 patients with high axial myopia. Based on axial length (AL), the participants were divided into three groups: group 1 (26 ≤ AL < 28 mm), group 2 (28 ≤ AL < 31 mm), and group 3 (≥31 mm). Scanning laser ophthalmoscopy imaging was used to analyze the retinal artery angle (Yugami correlated angle [YCA]). Retinal vascular densities (VDs) in both superficial capillary plexuses (SCPs) and deep capillary plexuses were evaluated. Fixation behavior, including retinal mean sensitivity (MS), macular fovea 2°, 4° fixation rate (P1, P2), and 68.2% bivariate contour ellipse area, were analyzed by microperimetry. Finally, the correlation between YCAs and AL, VDs, best-corrected visual acuity (BCVA), and fixation behavior was assessed.
Results:
The YCAs showed significant differences among the three groups (all P < 0.001, respectively). Compared to group 1, the YCA decreased in group 2 (P < 0.001) and continued to decrease in group 3 (P = 0.043). The correlation analysis revealed that smaller YCAs (YCA, YCA1/2, YCA1/4) were positively correlated with the longer AL (ρ = 0.580, 0.545, 0.448, P < 0.001) and lower VDs in any sector in SCPs (all P ≤ 0.05). Furthermore, smaller YCAs were positively correlated with decreased BCVA (ρ = 0.392, 0.387, 0.262; all P < 0.001) and reduced MS (ρ= 0.300, 0.269, 0.244; all P < 0.05).
Conclusions:
Smaller YCAs were correlated with longer AL, lower VD in SCP, decreased BCVA, and reduced MS. The YCAs might reflect vascular deformation caused by axial elongation and could potentially be useful in predicting visual function in high axial myopia.
Translational relevance:
The quantitative analysis of YCAs in fundus photography holds potential clinical value in predicting visual function in high axial myopia.
Purpose:
To compare the angle of retinal arteries and macular vessel density and foveal avascular zone (FAZ) in early stage familial exudative vitreoretinopathy (FEVR) patients with inner retinal layer (IRL) persistence with FEVR patients without IRL persistence and normal people.
Methods:
This study enrolled 113 early stage FEVR patients and 55 age-matched normal subjects. FEVR patients were divided into IRL group and non-IRL group based on the presence or absence of IRL in fovea. The angle of superior temporal and inferior temporal branch retinal arteries on ultra-wide-field fundus images were measured. Superficial and deep vessel density of whole image, fovea and parafovea, the area and perimeter of FAZ, A-circularity index (AI, perimeter/standard circle perimeter with equal area) and vessel density around the 300-μm width of the FAZ (FD), central macular thickness (CMT) on 3 mm × 3mm OCTA were measured.
Results:
30 FEVR patients in IRL group, 83 FEVR patients in non-IRL group, 55 normal people in control group were evaluated. BCVA were worst in IRL group (p < .001). The angle of retinal arteries was smaller in FEVR groups (p < .001) and were smallest in IRL group (p < .001). Superficial and deep vessel density of whole and parafovea area in FEVR patients were significantly lower than that in normal people (p < .05), AI were biggest (p = .01) and FD were smallest in IRL group (p < .001). CMT in IRL group were thicker than non-IRL group and control group (p < .05).
Conclusion:
Worse BCVA, smaller angle of retinal arteries (more vessels traction), lower macular vessel density, smaller and more irregular FAZ and thicker CMT were observed in FEVR patients with IRL persistence even in early stage.
Purpose:
To assess the association between physical activity and spectral-domain optical coherence tomography (SD-OCT)-measured rates of macular thinning in an adult population with primary open-angle glaucoma.
Methods:
The correlation between accelerometer-measured physical activity and rates of macular ganglion cell-inner plexiform layer (GCIPL) thinning was measured in 735 eyes from 388 participants of the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study. The association between accelerometer-measured physical activity and cross-sectional SD-OCT macular thickness was then assessed in 8862 eyes from 6152 participants available for analysis in the UK Biobank who had SD-OCT, ophthalmic, comorbidity, and demographic data.
Results:
Greater physical activity was associated with slower rates of macular GCIPL thinning in the PROGRESSA study (beta = 0.07 µm/y/SD; 95% confidence interval [CI], 0.03-0.13; P = 0.003) after adjustment for ophthalmic, demographic and systemic predictors of macular thinning. This association persisted in subanalyses of participants characterized as glaucoma suspects (beta = 0.09 µm/y/SD; 95% CI, 0.03-0.15; P = 0.005). Participants in the upper tertile (greater than 10,524 steps/d) exhibited a 0.22-µm/y slower rate of macular GCIPL thinning than participants in the lower tertile (fewer than 6925 steps/d): -0.40 ± 0.46 µm/y versus -0.62 ± 0.55 µm/y (P = 0.003). Both time spent doing moderate/vigorous activity and mean daily active calories were positively correlated with rate of macular GCIPL thinning (moderate/vigorous activity: beta = 0.06 µm/y/SD; 95% CI, 0.01-0.105; P = 0.018; active calories: beta = 0.06 µm/y/SD; 95% CI, 0.006-0.114; P = 0.032). Analysis among 8862 eyes from the UK Biobank revealed a positive association between physical activity and cross-sectional total macular thickness (beta = 0.8 µm/SD; 95% CI, 0.47-1.14; P < 0.001).
Conclusions:
These results highlight the potential neuroprotective benefits of exercise on the human retina.
Purpose:
To analyse optical coherence tomography (OCT)-derived inner nuclear layer (INL) and outer retinal complex (ORC) measurements relative to ganglion cell-inner plexiform layer (GCIPL) measurements in glaucoma.
Methods:
Glaucoma participants (n = 271) were categorised by 10-2 visual field defect type. Differences in GCIPL, INL and ORC thickness were calculated between glaucoma and matched healthy eyes (n = 548). Hierarchical cluster algorithms were applied to generate topographic patterns of retinal thickness change, with agreement between layers assessed using Cohen's kappa (κ). Differences in GCIPL, INL and ORC thickness within and outside GCIPL regions showing the greatest reductions and Spearman's correlations between layer pairs were compared with 10-2 mean deviation (MD) and pattern standard deviation (PSD) to determine trends with glaucoma severity.
Results:
Glaucoma participants with inferior and superior defects presented with concordant GCIPL and INL defects demonstrating mostly fair-to-moderate agreement (κ = 0.145-0.540), which was not observed in eyes with no or ring defects (κ = -0.067-0.230). Correlations (r) with MD and PSD were moderate and weak in GCIPL and INL thickness differences, respectively (GCIPL vs. MD r = 0.479, GCIPL vs. PSD r = -0.583, INL vs. MD r = 0.259, INL vs. PSD r = -0.187, p = <0.0001-0.002), and weak in GCIPL-INL correlations (MD r = 0.175, p = 0.004 and PSD r = 0.154, p = 0.01). No consistent patterns in ORC thickness or correlations were observed.
Conclusions:
In glaucoma, concordant reductions in macular INL and GCIPL thickness can be observed, but reductions in ORC thickness appear unlikely. These findings suggest that trans-synaptic retrograde degeneration may occur in glaucoma and could indicate the usefulness of INL thickness in evaluating glaucomatous damage.
Clinical relevance
With equivalent inner retinal thickness measurements compared to a more conventional composite optical coherence tomography (OCT) protocol, Widefield optical coherence tomography (WF-OCT) is a clinically viable, time-saving option facilitating detection of ocular pathologies within the central 55° of the retina.
Purpose
To compare ganglion cell-inner plexiform layer (GCIPL) thicknesses obtained using a single WF-OCT scan and standard composite OCT scans acquired in 9 fields of gaze (9F-OCT).
Methods
Thirteen healthy participants underwent WF-OCT and 9F-OCT using the Spectralis OCT. The GCIPL was automatically segmented with a manual review for 9F-OCT and was manually segmented for WF-OCT. After registration, differences in GCIPL thicknesses were compared using 95% confidence intervals computed from one-sample t-tests and Bland-Altman analyses. Location-specific differences in B-scan tilt were analysed using Spearman correlations and linear regression models. To determine whether B-scan tilt influences GCIPL measurements, regression models of tilt versus differences between perpendicular and axial GCIPL thickness were applied.
Results
While scattered locations demonstrated significant GCIPL thickness differences between WF-OCT and 9F-OCT, most differences did not exceed the axial pixel resolution of the instrument of 3.87 µm. Bland-Altman analyses indicated no notable bias using WF-OCT. Moderate correlations indicating significant location-specific differences in B-scan tilt were observed for temporal, central and inferior B-scans (r = −0.62 to 0.72), with linear regression models predicting a maximum difference in the tilt of 4.65°. The quadratic regression model indicated that at tilts greater than 27.3°, perpendicular GCIPL measurements become increasingly thin relative to axial measurements.
Conclusions
GCIPL thicknesses and B-scan tilts from WF-OCT are comparable to 9F-OCT, indicating that WF-OCT can be applied clinically to obtain valid inner retinal OCT measurements over 55° of the central retina with relative ease. However, for peripheral locations, B-scan tilt may need to be considered when measuring GCIPL thicknesses.
