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Nutrients Jul 2022Idiopathic intracranial hypertension (IIH) is a neurological disorder characterised by optic disc swelling secondary to raised intracranial pressure (ICP) of unknown... (Review)
Review
Idiopathic intracranial hypertension (IIH) is a neurological disorder characterised by optic disc swelling secondary to raised intracranial pressure (ICP) of unknown cause. Obesity is the most established and prevalent risk factor in developed countries. As obesogenic diets are high in calories and nutrient-poor, there may be associated nutritional deficiencies that contribute to the clinical presentation of IIH. Yet none, aside from iron deficiency, are currently included in the inclusion or exclusion criteria for the diagnosis of IIH. Our primary aim was to determine which micronutrient deficiencies, aside from iron deficiency, could present with optic disc swelling associated with or without intracranial hypertension that could potentially meet current IIH diagnostic criteria. To this end, we conducted a systematic search of articles published between 1 January 1980 and 18 December 2020 reporting cases of optic disc swelling associated with micronutrient deficiencies. In total, 65 cases met the eligibility criteria from initial searches: all were case reports and case series with a high risk of bias. Our findings suggest that patients with IIH or unexplained optic disc swelling ought to be screened, investigated, and treated for associated micronutrient deficiencies in vitamin A, B1 and B12; and weight loss interventions in IIH patients ought to promote better nutrition in addition to overall calorie restriction.
Topics: Humans; Intracranial Hypertension; Malnutrition; Micronutrients; Optic Disk; Papilledema; Pseudotumor Cerebri
PubMed: 35893919
DOI: 10.3390/nu14153068 -
European Journal of Ophthalmology Jan 2023To summarize the evidence available on optical coherence tomography angiography (OCTA) in patients with anterior ischemic optic neuropathy (AION). (Meta-Analysis)
Meta-Analysis
PURPOSE
To summarize the evidence available on optical coherence tomography angiography (OCTA) in patients with anterior ischemic optic neuropathy (AION).
METHODS
Systematic searches were conducted on PubMed, Embase, Web of Science, Scopus, Cochrane, and Google Scholar Databases. The quality assessment of the included studies was performed using Newcastle -Ottawa Scale. The data were extracted to an Excel sheet. Vessel density (VD) data were pooled by random effects model, presented as pooled percentage change (PPC), and weighted mean differences (WMD). Additional subgroup analysis was also conducted.
RESULTS
In initial searches in online databases, we found 3535 citations, and after screening and checking the titles and abstracts, 26 articles were ultimately eligible for our meta-analysis. The overall PPC of Intra-optic-disc (IOD) VD (-10.73%; p = 0.017, I = 0.0%; p = 0.898) was lower than that of radial peripapillary (RP) VD (-17.57%; p < 0.001, I = 44.3%; p = 0.002). The overall PPC of peripapillary choroid VD (-6.99%; p < 0.001, I = 0.0%; p = 0.766) was significant, but noticeably lower than the pooled percentage change of RPVD and IOD VD. The WMD of RPVD was significant when non-affected fellow eyes were compared to the healthy subjects' eyes (-36.26; p < 0.001, I = 0.0%; p = 0.706).
CONCLUSIONS
The central retinal artery and its branches might be the main vessels which are affected in AION. The superficial retina was more affected than choroid layer in AION. Also, radial peripapillary retinal nerve fibre layer was more affected than the IOD area. OCTA might be a suitable tool for prediction of AION in susceptible eyes.
Topics: Humans; Tomography, Optical Coherence; Optic Neuropathy, Ischemic; Optic Disk; Angiography; Retina; Fluorescein Angiography; Retinal Vessels
PubMed: 35844139
DOI: 10.1177/11206721221113681 -
Computer Methods and Programs in... Jun 2022The optic nerve head (ONH) represents the intraocular section of the optic nerve, which is prone to damage by intraocular pressure (IOP). The advent of optical... (Review)
Review
The optic nerve head (ONH) represents the intraocular section of the optic nerve, which is prone to damage by intraocular pressure (IOP). The advent of optical coherence tomography (OCT) has enabled the evaluation of novel ONH parameters, namely the depth and curvature of the lamina cribrosa (LC). Together with the Bruch's membrane minimum-rim-width (BMO-MRW), these seem to be promising ONH parameters for diagnosis and monitoring of retinal diseases such as glaucoma. Nonetheless, these OCT derived biomarkers are mostly extracted through manual segmentation, which is time-consuming and prone to bias, thus limiting their usability in clinical practice. The automatic segmentation of ONH in OCT scans could further improve the current clinical management of glaucoma and other diseases. This review summarizes the current state-of-the-art in automatic segmentation of the ONH in OCT. PubMed and Scopus were used to perform a systematic review. Additional works from other databases (IEEE, Google Scholar and ARVO IOVS) were also included, resulting in a total of 29 reviewed studies. For each algorithm, the methods, the size and type of dataset used for validation, and the respective results were carefully analysed. The results show a lack of consensus regarding the definition of segmented regions, extracted parameters and validation approaches, highlighting the importance and need of standardized methodologies for ONH segmentation. Only with a concrete set of guidelines, these automatic segmentation algorithms will build trust in data-driven segmentation models and be able to enter clinical practice.
Topics: Bruch Membrane; Glaucoma; Humans; Intraocular Pressure; Optic Disk; Tomography, Optical Coherence
PubMed: 35429812
DOI: 10.1016/j.cmpb.2022.106801 -
BMC Ophthalmology Feb 2022β-Zone parapapillary atrophy (β-PPA) is a common sign in patients with open-angle glaucoma (OAG). Some studies have suggested that β-PPA can aid in the diagnosis of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
β-Zone parapapillary atrophy (β-PPA) is a common sign in patients with open-angle glaucoma (OAG). Some studies have suggested that β-PPA can aid in the diagnosis of OAG. We performed a systematic review and meta-analysis of the prevalence and diagnostic ability of β-PPA in OAG.
METHODS
We performed a literature search in PubMed, Web of Science, Embase and Google Scholar from inception to 1st November, 2021. Both hospital-based and population-based studies that reported details of β-PPA in OAG were included.
RESULTS
We screened 1404 articles from these databases and ultimately included 24 articles in our meta-analysis. The prevalence of β-PPA in OAG was 0.73 (95% CI 0.67 to 0.78). The results of subgroup analysis by country revealed prevalence rates of 0.83 (95% CI 0.78 to 0.88) in Japan, 0.85 (95% CI 0.64 to 0.97) in Korea, 0.64 (95% CI 0.55 to 0.73) in the USA, 0.61 (95% CI 0.58 to 0.63) in Germany and 0.57 (95% CI 0.39 to 0.74) in China. Fundus photography, Heidelberg retina tomography (HRT), Heidelberg retina angiography (HRA) + indocyanine green angiography (ICGA), Spectral domain optical coherence tomography (SD-OCT)and Swept source optical coherence tomography(SS-OCT) values were 0.65 (95% CI 0.58 to 0.71), 0.70 (95% CI 0.50 to 0.86), 0.78 (95% CI 0.61 to 0.91), 0.77 (95% CI 0.65 to 0.88) and 0.99(95% CI 0.87 to 1.00) respectively. The sensitivity and specificity of β-PPA as a diagnostic marker were 0.78 (95% CI 0.68 to 0.85) and 0.63 (95% CI 0.51 to 0.73), respectively.
CONCLUSIONS
β-PPA is a potential diagnostic marker for OAG. However, a more detailed understanding of β-PPA characteristics is needed to improve the ability to predict OAG.
Topics: Atrophy; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Optic Atrophy; Optic Disk; Prevalence; Tomography, Optical Coherence
PubMed: 35151269
DOI: 10.1186/s12886-022-02282-5 -
Survey of Ophthalmology 2022Studies reporting alteration in retinal thickness using optical coherence tomography (OCT) have been performed in different populations with various degrees of... (Meta-Analysis)
Meta-Analysis Review
Studies reporting alteration in retinal thickness using optical coherence tomography (OCT) have been performed in different populations with various degrees of refractive error, producing inconsistent results. Therefore, we performed a meta-analysis to evaluate the alterations in retinal OCT measurements in myopic and hyperopic patients compared to controls. Evaluation of different retinal layers' thickness may have significance for developing novel approaches for preventing, diagnosing, and treating refractive errors and their complications. We searched PubMed and EMBASE to identify articles that reported OCT measurements of different retinal layers and regions, including macular, foveal, parafoveal, perifoveal, foveolar, ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell and inner plexiform layer (GC-IPL) thickness in addition to macular volume, and optic disc area in myopes and hyperopes comparing their differences with controls. We applied either a fixed-effects or random-effects model for the meta-analysis of these differences based on the assessed heterogeneity level. Furthermore, subgroup analyses and metaregression, as well as publication bias and quality assessment, were conducted for the eligible studies. Forty-seven studies with a total of 12223 eyes, including 8600 cases and 3623 non-cases, are included in this meta-analysis. Our results showed that, in comparison to controls, highly myopic eyes had a significantly lower value for mean macular thickness, macular GCC, macular GC-IPL, parafoveal, perifoveal, foveal, foveolar, RNFL, and pRNFL thickness. Compared to controls, moderately myopic eyes showed a significantly thinner mean macular GCC layer and pRNFL. On the other hand, hyperopic eyes had significantly thicker average pRNFL than controls. Several other significant differences were also observed in various regional analyses. The findings of the current study affirm the retinal OCT measurement differences between myopic and hyperopic eyes compared to controls, emphasizing OCT measurements' advantages as potential biomarkers of ocular pathologies.
Topics: Humans; Nerve Fibers; Optic Disk; Refractive Errors; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 34343537
DOI: 10.1016/j.survophthal.2021.07.007 -
International Ophthalmology Nov 2021To evaluate the diagnostic value of laser speckle flowgraphy (LSFG) in glaucoma by investigating the mean blur rate (MBR) in the optic nerve head. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To evaluate the diagnostic value of laser speckle flowgraphy (LSFG) in glaucoma by investigating the mean blur rate (MBR) in the optic nerve head.
METHODS
Systematic literature search was performed in the CENTRAL, Web of Science, PubMed, and EMBASE databases to obtain relevant studies published until December 2020 without restrictions. The Newcastle-Ottawa Scale (NOS) was used for study quality assessment. The outcome measures included the MBRs of the entire (MA), vascular (MV), and tissue (MT) areas. Subgroup analyses were performed according to glaucoma type. All data were analyzed using RevMan and Comprehensive Meta-Analysis 3.3 software.
RESULTS
Fifteen studies, including 692 glaucomatous and 386 healthy eyes, were included. Of these, 11 studies reported the MA, MV, and MT, three studies only reported MT, and one study only reported MV. All were classified as case-control studies and had good NOS scores. The meta-analysis showed that the MA and MT were significantly reduced in glaucomatous eyes (mean difference [MD] - 5.59, 95% confidence interval [CI] - 6.19 to - 4.99, p = 0.1; MD - 2.2, 95% CI - 2.49 to - 1.91, p = 0.07, respectively) with moderate heterogeneity (p = 0.1, I = 38%; p = 0.07, I = 39%, respectively). There was also a significant difference in the MV between glaucomatous and healthy eyes (MD - 5.92, 95% CI - 7.77 to - 4.07) with significant heterogeneity (p = 0.0003, I = 69%). The subgroup analyses revealed significant differences in the MBR among different glaucoma types.
CONCLUSIONS
Glaucoma is closely related to ocular blood flow changes. This meta-analysis suggests that LSFG is a feasible diagnostic tool for glaucoma. However, further longitudinal prospective studies are needed.
Topics: Blood Flow Velocity; Glaucoma; Humans; Laser-Doppler Flowmetry; Lasers; Optic Disk; Regional Blood Flow
PubMed: 34327617
DOI: 10.1007/s10792-021-01954-3 -
Acta Ophthalmologica Mar 2022To evaluate microvascular alterations with optical coherence tomography angiography (OCTA) in eyes with non-arteritic anterior ischaemic optic neuropathy (NAION) and the... (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate microvascular alterations with optical coherence tomography angiography (OCTA) in eyes with non-arteritic anterior ischaemic optic neuropathy (NAION) and the unaffected fellow eyes.
DESIGN
Systematic review and meta-analysis.
METHODS
A comprehensive literature search was conducted in the PubMed and Embase databases through 6 September 2020, to identify the studies on NAION and the unaffected fellow eyes using OCTA. Eligible studies and data of interest were extracted and analysed by RevMan Software v. 5.4 and Stata Software v.14.0. The weighted mean differences and 95% confidence intervals were used to assess the strength of the association.
RESULTS
Seventeen observational comparative studies, including 379 eyes with NAION, 175 unaffected contralateral eyes and 470 eyes of healthy controls, were identified. Compared to those of the healthy controls, the perfusion density (PD) of radial peripapillary capillary (RPC) and peripapillary superficial capillary plexus (ppSCP) of NAION were significantly lower. Moreover, the PD of the macular SCP (mSCP) in NAION was significantly reduced in the whole image, superior quadrant and temporal quadrant, while the macular deep capillary plexus (mDCP) showed a decreasing PD only within the whole image. Between unaffected fellow eyes and healthy eyes, significant differences of PD were demonstrated in the whole image and some peripapillary regions of the RPC and ppSCP.
CONCLUSION
Our results suggested that compared to those of healthy controls, the eyes affected by NAION and unaffected fellow eyes demonstrated significant microvascular impairments in different regions. Between acute and non-acute NAION, macular OCTA parameters showed different characteristic patterns.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Observational Studies as Topic; Optic Disk; Optic Neuropathy, Ischemic; Retinal Vessels; Tomography, Optical Coherence
PubMed: 34155823
DOI: 10.1111/aos.14930 -
The British Journal of Ophthalmology May 2022Optical coherence tomography angiography (OCTA) allows the study of vessel density (VD). We intended to perform a systematic review of studies focusing on longitudinal...
BACKGROUND/AIMS
Optical coherence tomography angiography (OCTA) allows the study of vessel density (VD). We intended to perform a systematic review of studies focusing on longitudinal changes in peripapillary and macular VD measurements in glaucoma.
METHODS
A search was performed across MEDLINE, Scopus, ISI Web of Science and Google Scholar, using the following query from inception until 20 September 2019: (("optical coherence tomography angiography"[tiab]) OR (optical coherence tomography angiography[MeSH]) OR ("OCTA"[tiab]) OR ("OCT-A"[tiab]) OR ("angio-OCT"[tiab]) OR ("OCT- angiography"[tiab]) OR ("OCT-angio"[tiab]) OR ("OCT-angiographie"[tiab])) AND (glaucom*[tiab] OR glaucoma[MeSH]). Prospective studies that quantitatively assessed the longitudinal changes in VD in glaucoma with at least 3 months of follow-up were included.
RESULTS
Ten out of 4516 studies were included. The rate of VD change in glaucoma varied from 0.036/year to 1.08/year and 1.3% to 3.2% per year, with significantly different rates between glaucoma and healthy controls. Five studies assessed VD change after glaucoma surgery, obtaining variable results, ranging from a temporary VD decrease to increase after 3 months. Meta-analysis was not possible due to a wide variation in methods, measurements and region of VD.
CONCLUSION
OCTA is a non-invasive technology, which shows promise in glaucoma. Measures should be taken to increase the quality and standardise the methodology of VD measures in OCTA longitudinal studies, for future meta-analyses.
Topics: Fluorescein Angiography; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Optic Disk; Prospective Studies; Retinal Vessels; Tomography, Optical Coherence
PubMed: 33452184
DOI: 10.1136/bjophthalmol-2020-318166 -
Acta Ophthalmologica Nov 2021To evaluate the basic characteristics of optic disc pit maculopathy (ODPM) and the efficacies of pars plana vitrectomy (PPV) treatment with different adjunctive... (Meta-Analysis)
Meta-Analysis
PURPOSE
To evaluate the basic characteristics of optic disc pit maculopathy (ODPM) and the efficacies of pars plana vitrectomy (PPV) treatment with different adjunctive strategies.
METHODS
The databases PubMed, EMBASE and Ovid up to April 2020 were searched to identify relevant studies. Statistical analyses were conducted with R software version 3.6.3.
RESULTS
Fifty-nine studies were eventually included for different aspects of statistical analyses. The pooling results suggest the general incidence of maculopathy in optic disc pit (ODP) is 51%, and the rate of serous macular detachment and retinoschisis is 49% and 58%, respectively. The incidence of sub-retinal fluid (SRF) only is 10%, intra-retinal retinal (IRF) fluid only is 14%, and SRF plus IRF is 69%. A lamellar macular hole (LMH) is present in 53% of cases, and 58% have communication between the macula with the pit. The incidence of posterior vitreous detachment (PVD), vitreo-papillary traction and vitreomacular traction (VMT) is 7%, 28% and 13%, respectively. Besides, the rate of complete anatomic success and visual improvement after PPV are both around 85%. Subgroup analysis reveals the anatomic, and visual success rates of PPV alone are 89% and 100%, respectively. Gas tamponade, laser or internal limiting membrane peeling (ILMP) during vitrectomy are less promising, while PPV with ILM flap stuffing could achieve better outcomes than cases without it.
CONCLUSION
Optic disc pit-associated maculopathy has different fundus characteristics. Based on the current evidence, PPV is effective for ODPM, and the combined application of gas tamponade, laser and ILMP should be used with caution.
Topics: Eye Abnormalities; Humans; Macular Degeneration; Optic Disk; Tomography, Optical Coherence; Vitrectomy
PubMed: 33421324
DOI: 10.1111/aos.14730 -
Journal of Neurology Nov 2021The peripapillar nerve fiber layer (pRNFL) thinning in different retinal quadrants or sectors remains controversy. We conducted a systematic review and meta-analysis on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
The peripapillar nerve fiber layer (pRNFL) thinning in different retinal quadrants or sectors remains controversy. We conducted a systematic review and meta-analysis on the pattern of pRNFL thinning in Parkinson's disease (PD) patients to provide a biomarker for PD differential diagnosis.
METHODS
We systematically searched PubMed and EMBASE to identify studies comparing pRNFL thickness in PD patients and health controls using spectral domain-optical coherence tomography from inception to April 25, 2020. Random effects mode was used to pool mean difference (μm) of the average thickness of pRNFL and the thickness of pRNFL in four quadrants (superior, inferior, nasal and temporal) and in the subdivisions of superior (superonasal and superotemporal sectors) and inferior quadrants (inferonasal and inferotemporal sectors) between PD patients and health controls.
RESULTS
We included 32 studies (33 sets of data) enrolling 2126 PD eyes and 2318 health control eyes. Between the eyes of PD patients and that of health controls, the pooled mean difference (μm) of average pRNFL was - 4.85 (95% CI [- 6.12, - 3.58]); the pooled mean difference (μm) of four quadrants were - 2.30 (95% CI [- 3.32, - 1.28], nasal), - 2.74 (95% CI [- 4.34, - 1.14], temporal), - 5.24 (95% CI [- 7.04, - 3.43], superior) and - 7.29 (95% CI [- 9.23, - 5.34], inferior); those of four sectors were - 5.16 (95% CI [- 7.70, - 2.62], superotemporal), - 3.55 (95% CI [- 5.87, - 1.23], superonasal), - 9.19 (95% [- 13.27, - 5.12], inferotemporal) and - 7.62 (95% CI [- 11.84, - 3.40], inferonasal).
CONCLUSION
In PD patients, pRNFL thinning followed a specific pattern with inferotemporal thinning most and nasal quadrant thinning least.
Topics: Humans; Nerve Fibers; Optic Disk; Parkinson Disease; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 32691237
DOI: 10.1007/s00415-020-10094-0