-
Neurology Oct 2023Cadaveric studies have shown disease-related neurodegeneration and other morphological abnormalities in the retina of individuals with Parkinson disease (PD); however,...
BACKGROUND AND OBJECTIVES
Cadaveric studies have shown disease-related neurodegeneration and other morphological abnormalities in the retina of individuals with Parkinson disease (PD); however, it remains unclear whether this can be reliably detected with in vivo imaging. We investigated inner retinal anatomy, measured using optical coherence tomography (OCT), in prevalent PD and subsequently assessed the association of these markers with the development of PD using a prospective research cohort.
METHODS
This cross-sectional analysis used data from 2 studies. For the detection of retinal markers in prevalent PD, we used data from AlzEye, a retrospective cohort of 154,830 patients aged 40 years and older attending secondary care ophthalmic hospitals in London, United Kingdom, between 2008 and 2018. For the evaluation of retinal markers in incident PD, we used data from UK Biobank, a prospective population-based cohort where 67,311 volunteers aged 40-69 years were recruited between 2006 and 2010 and underwent retinal imaging. Macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GCIPL), and inner nuclear layer (INL) thicknesses were extracted from fovea-centered OCT. Linear mixed-effects models were fitted to examine the association between prevalent PD and retinal thicknesses. Hazard ratios for the association between time to PD diagnosis and retinal thicknesses were estimated using frailty models.
RESULTS
Within the AlzEye cohort, there were 700 individuals with prevalent PD and 105,770 controls (mean age 65.5 ± 13.5 years, 51.7% female). Individuals with prevalent PD had thinner GCIPL (-2.12 μm, 95% CI -3.17 to -1.07, = 8.2 × 10) and INL (-0.99 μm, 95% CI -1.52 to -0.47, = 2.1 × 10). The UK Biobank included 50,405 participants (mean age 56.1 ± 8.2 years, 54.7% female), of whom 53 developed PD at a mean of 2,653 ± 851 days. Thinner GCIPL (hazard ratio [HR] 0.62 per SD increase, 95% CI 0.46-0.84, = 0.002) and thinner INL (HR 0.70, 95% CI 0.51-0.96, = 0.026) were also associated with incident PD.
DISCUSSION
Individuals with PD have reduced thickness of the INL and GCIPL of the retina. Involvement of these layers several years before clinical presentation highlight a potential role for retinal imaging for at-risk stratification of PD.
Topics: Humans; Female; Adult; Middle Aged; Aged; Male; Retinal Ganglion Cells; Parkinson Disease; Tomography, Optical Coherence; Retrospective Studies; Prospective Studies; Cross-Sectional Studies; Nerve Fibers; Retina
PubMed: 37604659
DOI: 10.1212/WNL.0000000000207727 -
Annals of African Medicine 2023The purpose of the study is to evaluate choroidal thickness (CT) and the effect of age and gender in healthy Africans using enhanced depth imaging spectral-domain...
PURPOSE
The purpose of the study is to evaluate choroidal thickness (CT) and the effect of age and gender in healthy Africans using enhanced depth imaging spectral-domain optical coherence tomography.
MATERIALS AND METHODS
In 172 eyes of 88 volunteers, the CT in the central subfoveal (CSF) area and at 2.5 mm superior, inferior, nasal, and temporal quadrants was measured. Four eyes were excluded due to poor image quality and image decentration. Simple linear regression was used to measure the effect of age on CT, and statistical analysis was done using IBM SPSS Statistics version 22.
RESULTS
The were 88 male and 84 female eyes, aged 30-80 years. The mean CT was CSF 265.44 ± 6.2 μm; inferior 256.19 ± 70.6 μm; superior 249.92 ± 76.2 μm; temporal 235.51 ± 70.3 μm; and nasal 199.53 ± 69.8 μm. The choroid was thickest in the CSF > Inferior > Superior > Temporal, and the nasal quadrant was thinnest in all age groups. There was a considerable decrease in the CSF with increasing age (P < 0.001). CT in males and females was similar since the difference in mean CSF CT between the genders was 2.085 μm (P = 0.858). Menopausal females had thinner CSF CT compared to premenopausal females (P < 0.001), but this was due to the aging effect.
CONCLUSION
CT decreases significantly with increasing age but shows no gender difference in Africans. A comparison of CT studies from other ethnic nationalities shows some similarity with CT in Africans, suggesting that CT findings from other ethnic groups can be extrapolated to Africans.
Topics: Humans; Male; Female; Cross-Sectional Studies; Choroid; Tomography, Optical Coherence
PubMed: 38358150
DOI: 10.4103/aam.aam_184_22 -
Survey of Ophthalmology 2023We compare efficacy of treatments for chronic central serous chorioretinopathy (CSCR) > 3 months. Four treatment classes were considered: photodynamic therapy (PDT),... (Meta-Analysis)
Meta-Analysis Review
We compare efficacy of treatments for chronic central serous chorioretinopathy (CSCR) > 3 months. Four treatment classes were considered: photodynamic therapy (PDT), subthreshold laser therapies (SLT), mineralocorticoid receptor antagonists (MRA) and antivascular endothelial growth factor (anti-VEGF) agents. Pairwise and network meta-analyses (NMA) of the primary outcomes (complete resolution of subretinal fluid (SRF), mean change in best corrected visual acuity (BCVA as logMAR) and mean change in SRF) and secondary outcomes (mean change in central retinal thickness, and central choroidal thickness (μm), recurrence of SRF, and adverse events) at 3, 6, and 12 months were compared. Confidence in Network Meta-Analysis (CINeMA) informed the certainty of NMA evidence. Eleven RCTs of 458 eyes (450 patients) were included. NMA at 3 months showed that both PDT and SLT were superior to control for resolution of SRF (OR 4.83; 95% CI 1.72-13.55 and 2.27; 1.14-4.49, respectively) and SLT was superior to control for improving BCVA (MD -0.10; -0.17 to -0.04). PDT was superior to SLT for improving CRT (MD -42.88; -75.27 to -10.50). On probability ranking, PDT and SLT were consistently the best-ranked treatments for each outcome at 3 months, but low confidence of evidence and paucity of studies preclude definitive conclusions.
Topics: Humans; Central Serous Chorioretinopathy; Network Meta-Analysis; Retina; Laser Therapy; Photochemotherapy; Tomography, Optical Coherence; Photosensitizing Agents; Chronic Disease; Fluorescein Angiography; Retrospective Studies; Treatment Outcome
PubMed: 36931437
DOI: 10.1016/j.survophthal.2023.03.001 -
Brain : a Journal of Neurology Nov 2023The link between white matter hyperintensities (WMH) and cortical thinning is thought to be an important pathway by which WMH contributes to cognitive deficits in...
The link between white matter hyperintensities (WMH) and cortical thinning is thought to be an important pathway by which WMH contributes to cognitive deficits in cerebral small vessel disease (SVD). However, the mechanism behind this association and the underlying tissue composition abnormalities are unclear. The objective of this study is to determine the association between WMH and cortical thickness, and the in vivo tissue composition abnormalities in the WMH-connected cortical regions. In this cross-sectional study, we included 213 participants with SVD who underwent standardized protocol including multimodal neuroimaging scans and cognitive assessment (i.e. processing speed, executive function and memory). We identified the cortex connected to WMH using probabilistic tractography starting from the WMH and defined the WMH-connected regions at three connectivity levels (low, medium and high connectivity level). We calculated the cortical thickness, myelin and iron of the cortex based on T1-weighted, quantitative R1, R2* and susceptibility maps. We used diffusion-weighted imaging to estimate the mean diffusivity of the connecting white matter tracts. We found that cortical thickness, R1, R2* and susceptibility values in the WMH-connected regions were significantly lower than in the WMH-unconnected regions (all Pcorrected < 0.001). Linear regression analyses showed that higher mean diffusivity of the connecting white matter tracts were related to lower thickness (β = -0.30, Pcorrected < 0.001), lower R1 (β = -0.26, Pcorrected = 0.001), lower R2* (β = -0.32, Pcorrected < 0.001) and lower susceptibility values (β = -0.39, Pcorrected < 0.001) of WMH-connected cortical regions at high connectivity level. In addition, lower scores on processing speed were significantly related to lower cortical thickness (β = 0.20, Pcorrected = 0.030), lower R1 values (β = 0.20, Pcorrected = 0.006), lower R2* values (β = 0.29, Pcorrected = 0.006) and lower susceptibility values (β = 0.19, Pcorrected = 0.024) of the WMH-connected regions at high connectivity level, independent of WMH volumes and the cortical measures of WMH-unconnected regions. Together, our study demonstrated that the microstructural integrity of white matter tracts passing through WMH is related to the regional cortical abnormalities as measured by thickness, R1, R2* and susceptibility values in the connected cortical regions. These findings are indicative of cortical thinning, demyelination and iron loss in the cortex, which is most likely through the disruption of the connecting white matter tracts and may contribute to processing speed impairment in SVD, a key clinical feature of SVD. These findings may have implications for finding intervention targets for the treatment of cognitive impairment in SVD by preventing secondary degeneration.
Topics: Humans; Cerebral Cortical Thinning; Cross-Sectional Studies; Cognition Disorders; White Matter; Cerebral Small Vessel Diseases; Demyelinating Diseases; Magnetic Resonance Imaging
PubMed: 37366338
DOI: 10.1093/brain/awad220 -
JAMA Ophthalmology Jul 2023Diagnosis of glaucoma in highly myopic eyes is challenging. This study compared the glaucoma detection utility of various optical coherence tomography (OCT) parameters...
IMPORTANCE
Diagnosis of glaucoma in highly myopic eyes is challenging. This study compared the glaucoma detection utility of various optical coherence tomography (OCT) parameters for high myopia.
OBJECTIVE
To compare the diagnostic accuracy of single OCT parameters, the University of North Carolina (UNC) OCT Index, and the temporal raphe sign for discrimination of glaucoma in patients with high myopia.
DESIGN, SETTING, AND PARTICIPANTS
This was a retrospective cross-sectional study conducted from January 1, 2014, and January 1, 2022. Participants with high myopia (axial length ≥26.0 mm or spherical equivalent ≤-6 diopters) plus glaucoma and participants with high myopia without glaucoma were recruited from a single tertiary hospital in South Korea.
EXPOSURES
Macular ganglion cell-inner plexiform layer (GCIPL) thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured in each participant. The UNC OCT scores and the temporal raphe sign were checked to compare diagnostic utility. Decision tree analysis with single OCT parameters, the UNC OCT Index, and the temporal raphe sign were also applied.
MAIN OUTCOME AND MEASURES
Area under the receiver operating characteristic curve (AUROC).
RESULTS
A total of 132 individuals with high myopia and glaucoma (mean [SD] age, 50.0 [11.7] years; 78 male [59.1%]) along with 142 individuals with high myopia without glaucoma (mean [SD] age, 50.0 [11.3] years; 79 female [55.6%]) were included in the study. The AUROC of the UNC OCT Index was 0.891 (95% CI, 0.848-0.925). The AUROC of temporal raphe sign positivity was 0.922 (95% CI, 0.883-0.950). The best single OCT parameter was inferotemporal GCIPL thickness (AUROC, 0.951; 95% CI, 0.918-0.973), and its AUROC difference from the UNC OCT Index, temporal raphe sign, mean RNFL thickness, and ONH rim area was 0.060 (95% CI, 0.016-0.103; P = .007); 0.029 (95% CI, -0.009 to 0.068; P = .13), 0.022 (95% CI, -0.012-0.055; P = .21), and 0.075 (95% CI, 0.031-0.118; P < .001), respectively.
CONCLUSIONS AND RELEVANCE
Results of this cross-sectional study suggest that in discriminating glaucomatous eyes in patients with high myopia, inferotemporal GCIPL thickness yielded the highest AUROC value. The RNFL thickness and GCIPL thickness parameters may play a greater role in glaucoma diagnosis than the ONH parameters in high myopia.
Topics: Humans; Middle Aged; Tomography, Optical Coherence; Retrospective Studies; Cross-Sectional Studies; Retinal Ganglion Cells; Glaucoma; ROC Curve; Myopia
PubMed: 37200038
DOI: 10.1001/jamaophthalmol.2023.1717 -
The Angle Orthodontist Nov 2023To evaluate gingival phenotype (GP) and thickness (GT) using visual, probing, and ultrasound (US) methods and to assess the accuracy and consistency of clinicians to...
OBJECTIVES
To evaluate gingival phenotype (GP) and thickness (GT) using visual, probing, and ultrasound (US) methods and to assess the accuracy and consistency of clinicians to visually identify GP.
MATERIALS AND METHODS
The GP and GT of maxillary and mandibular anterior teeth in 29 orthodontic patients (mean age 25 ± 7.5 years) were assessed using probing and US by a single examiner. General dentist and dental specialist assessors (n = 104) were shown intraoral photographs of the patients, including six repeated images, and asked to identify the GP via a questionnaire.
RESULTS
An increasing trend in GT values of thin, medium, and thick biotype probe categories was found, though this was not statistically significant (P = .188). Comparison of probing method to determinations of GT made by US yielded slight agreement (κ = 0.12). Using the visual method, assessors' identification of the second GP determination ranged from poor to moderate agreement (κ = 0.29 to κ = 0.53).
CONCLUSIONS
The probe method is sufficient in differentiating between different categories of GP. However, further research is required to assess the sensitivity of the probe method in recognizing phenotypes in the most marginal of cases. Assessors using the visual method lack the ability to identify GP accurately and consistently among themselves.
Topics: Humans; Adolescent; Young Adult; Adult; Incisor; Gingiva; Maxilla; Photography, Dental; Ultrasonics; Phenotype
PubMed: 37407506
DOI: 10.2319/081622-573.1 -
Advanced Science (Weinheim,... Jul 2023Nanosized perovskite ferroelectrics are widely employed in several electromechanical, photonics, and thermoelectric applications. Scaling of ferroelectric materials...
Nanosized perovskite ferroelectrics are widely employed in several electromechanical, photonics, and thermoelectric applications. Scaling of ferroelectric materials entails a severe reduction in the lattice (phonon) thermal conductivity, particularly at sub-100 nm length scales. Such thermal conductivity reduction can be accurately predicted using the information of phonon mean free path (MFP) distribution. The current understanding of phonon MFP distribution in perovskite ferroelectrics is still inconclusive despite the critical thermal management implications. Here, high-quality single-crystalline barium titanate (BTO) thin films, a representative perovskite ferroelectric material, are grown at several thicknesses. Using experimental thermal conductivity measurements and first-principles based modeling (including four-phonon scattering), the phonon MFP distribution is determined in BTO. The simulation results agree with the measured thickness-dependent thermal conductivity. The results show that the phonons with sub-100 nm MFP dominate the thermal transport in BTO, and phonons with MFP exceeding 10 nm contribute ≈35% to the total thermal conductivity, in significant contrast to previously published experimental results. The experimentally validated phonon MFP distribution is consistent with the theoretical predictions of other complex crystals with strong anharmonicity. This work paves the way for thermal management in nanostructured and ferroelectric-domain-engineered systems for oxide perovskite-based functional materials.
PubMed: 37092575
DOI: 10.1002/advs.202301273 -
Clinical and Experimental Hypertension... Dec 2023This study intends to investigate the correlation between blood pressure variability (BPV) levels and the use of optical coherence tomography (OCT) and optical coherence...
PURPOSE
This study intends to investigate the correlation between blood pressure variability (BPV) levels and the use of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) to measure retinal microvasculature in hypertensive patients.
METHODS
All individuals in the study had 24-hour ambulatory blood pressure monitoring and bilateral OCT and OCTA exams, and only data from the right eye were analyzed statistically.
RESULTS
The study included 170 individuals, with 60 in the control group. The experimental group was separated into two groups based on the average real variability (ARV) median, with 55 in the low ARV group and 55 in the high ARV group. The mean thicknesses of the Retinal Nerve Fiber Layer (RNFL), internal limiting membrane-retinal pigment epithelial cell layer (ILM-RPE), vessel density (VD), and perfusion density (PD) in the high-ARV group were substantially lower in the low-ARV and control groups (p<0.05). Multiple linear regression analysis revealed that disease duration, age, and 24 h diastolic standard deviation all affected RNFL mean thickness (p<0.05). VD and PD were influenced by disease duration, systolic-ARV, daytime systolic blood pressure, intraocular pressure(IOP), and best-corrected visual acuity (BCVA) (p<0.05). And the change in VD was connected to best-corrected visual acuity.
CONCLUSION
Hypertensive retinopathy is related to BPV. In clinical practice, we can assess the degree of BPV and retinopathy in hypertensive patients to track the progression of hypertension-mediated organ damage (HMOD). Correction of BPV may help treat or postpone the progression of HOMD.
Topics: Humans; Young Adult; Adult; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Hypertensive Retinopathy; Hypertension; Retina
PubMed: 37120839
DOI: 10.1080/10641963.2023.2205050 -
BMC Cardiovascular Disorders Aug 2023Migraine with aura is associated with an increased risk of cardiovascular disease, yet the pathophysiology is unknown. Suggested underlying mechanisms of aura formation...
BACKGROUND
Migraine with aura is associated with an increased risk of cardiovascular disease, yet the pathophysiology is unknown. Suggested underlying mechanisms of aura formation point into the direction of an abnormal vasoreactivity that also extends to the extracranial vasculature.
METHODS
In the Early Vascular Ageing Tyrol study, a community-based non-randomized controlled trial conducted in 45 schools and companies in Tyrol (Austria) and South-Tyrol (Italy) between May 2015 and September 2018 aiming to increase cardiovascular health in adolescents, headache syndromes were classified according to the International Classification of Headache Disorders in a face-to-face interview. Carotid-femoral pulse-wave-velocity was measured by applanation tonometry and carotid intima-media-thickness by high-resolution ultrasound of the distal common carotid arteries. Differences in pulse-wave-velocity and carotid intima-media-thickness in youngsters with migraine with aura were compared respectively to those without headache and with other headaches by multivariable linear regression analysis.
RESULTS
Of the 2102 study participants 1589 were aged 14 to 19 (mean 16.8) years and had complete data. 43 (2.7%) reported migraine with aura and 737 (46.4%) other headaches. Mean pulse-wave-velocity was 6.17 m/s (± 0.85) for migraine with aura, 6.06 m/s (± 0.82) for all other headaches and 6.15 (0.95) m/s for participants without headaches. Carotid intima-media-thickness was 411.3 µm (± 43.5) for migraine with aura, 410.9 µm (± 46.0) for all other headaches and 421.6 µm (± 48.4) for participants without headaches. In multivariable linear regression analysis, we found no differences in carotid-femoral pulse-wave-velocity or carotid intima-media-thickness in young subjects with migraine with aura, all other headaches, or no headaches.
CONCLUSIONS
In line with previous large-scale studies in adults, we could not demonstrate relevant associations of migraine with aura with markers of arterial stiffness or subclinical atherosclerosis making early vascular ageing an unlikely pathophysiological link between migraine with aura and cardiovascular diseases.
TRIAL REGISTRATION
First registered on ClinicalTrials.gov 29/04/2019 (NCT03929692).
Topics: Adult; Humans; Adolescent; Migraine with Aura; Carotid Intima-Media Thickness; Atherosclerosis; Cardiovascular Diseases; Aging; Headache; Epilepsy; Vascular Stiffness
PubMed: 37528337
DOI: 10.1186/s12872-023-03409-2