Postural effects on spontaneous retinal venous pulsations in healthy individuals

© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd Purpose: To assess amplitudes of spontaneous retinal venous pulsations (SVP) in three various postures (sitting, supine and lateral decubitus) in healthy individuals. Methods: Thirty participants (28 ± 8 years, 25 females) were included in the study. Intraocular pressure (IOP), blood pressure (BP) and SVP's were measured at three different postures using a calibrated Tono-Pen applanation tonometer, a digital sphygmomanometer, and a custom-built handheld video ophthalmoscope, respectively. Retinal venous pulsations (SVP) amplitudes were extracted from the retinal videos using a custom written MATLAB algorithm. Mean arterial pressure (MAP = (systolic + 2diastolic)/3) and mean ocular perfusion pressure (MOPP = (2/3 MAP)-IOP) were also calculated at each posture. A one-way ANOVA was applied to each parameter to determine any significant difference for the various postural changes. Results: Mean IOP increased (p < 0.0001) and mean SVP decreased (p < 0.0001) from sitting to supine. The mean IOP (mmHg) and SVP (MU; measuring units) in sitting, supine and lateral decubitus were 16.2 ± 2, 19.4 ± 4, 19.8 ± 2 mmHg and 5.8 ± 2, 4.5 ± 2, and 4.7 ± 2 MU, respectively. Mean arterial pressure (MAP) and MOPP also decreased significantly from sitting to supine (p < 0.001, p < 0.001) and sitting to lateral decubitus (p < 0.05, p < 0.01). There were no significant differences between IOP, SVP, MAP or MOPP during a postural modification from supine to lateral decubitus. Conclusions: In this study, we showed a significant reduction in SVP amplitudes and a significant increase in IOP from sitting to supine position in a healthy young cohort. This supports the rationale to further study such phenomenon in ocular conditions such as glaucoma to determine whether relative SVP change, for a similar postural change, can reveal early signs of vascular dysfunction

Correlation of retinal nerve fibre layer thickness and spontaneous retinal venous pulsations in glaucoma and normal controls

© 2015 Golzan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Purpose: To study the relationship between amplitude of spontaneous retinal venous pulsatility (SRVP) and retinal nerve fibre layer (RNFL) thickness in glaucomatous eyes, and to determine if this parameter may be a potential marker for glaucoma severity. Method: 85 subjects including 50 glaucoma (21 males, 67±10 yrs) and 35 normals (16 males, 62±11 yrs) were studied. SRVP amplitude was measured using the Dynamic Vessel Analyser (DVA, Imedos, Germany) at four regions of the retina simultaneously within one disc diameter from the optic disc - temporal-superior (TS), nasal-superior (NS), temporal-inferior (TI) and nasal-inferior (NI)). This was followed by RNFL thickness measurement using spectral domain optical coherence tomography (Spectralis OCT). The correlation between SRVP amplitude and corresponding sectoral RNFL thickness was assessed by means of non-linear regression (i.e. logarithmic). Linear regression was also applied and slopes were compared using analysis of covariance (ANCOVA). Results: Greater SRVP amplitude was associated with thicker RNFL. Global SRVP amplitude was significantly lower in glaucoma eyes compared with normals (p0.05). Since the slopes are not significantly different, it is possible to calculate one slope for all the data. The pooled slope equals 10.8 (i.e. RNFL = 10.8SRVP+41)

A combined convolutional and recurrent neural network for enhanced glaucoma detection.

Glaucoma, a leading cause of blindness, is a multifaceted disease with several patho-physiological features manifesting in single fundus images (e.g., optic nerve cupping) as well as fundus videos (e.g., vascular pulsatility index). Current convolutional neural networks (CNNs) developed to detect glaucoma are all based on spatial features embedded in an image. We developed a combined CNN and recurrent neural network (RNN) that not only extracts the spatial features in a fundus image but also the temporal features embedded in a fundus video (i.e., sequential images). A total of 1810 fundus images and 295 fundus videos were used to train a CNN and a combined CNN and Long Short-Term Memory RNN. The combined CNN/RNN model reached an average F-measure of 96.2% in separating glaucoma from healthy eyes. In contrast, the base CNN model reached an average F-measure of only 79.2%. This proof-of-concept study demonstrates that extracting spatial and temporal features from fundus videos using a combined CNN and RNN, can markedly enhance the accuracy of glaucoma detection

Cognitive Performance on the Montreal Cognitive Assessment Test and Retinal Structural and Functional Measures in Glaucoma

Glaucoma, the leading cause of irreversible blindness, is classified as a neurodegenerative disease, and its incidence increases with age. Pathophysiological changes, such as the deposition of amyloid-beta plaques in the retinal ganglion cell layer, as well as neuropsychological changes, including cognitive decline, have been reported in glaucoma. However, the association between cognitive ability and retinal functional and structural measures in glaucoma, particularly glaucoma subtypes, has not been studied. We studied the association between cognitive ability and the visual field reliability indices as well as the retinal ganglion cell (RGC) count estimates in a cohort of glaucoma patients. Methods: A total of 95 eyes from 61 glaucoma patients were included. From these, 20 were normal-tension glaucoma (NTG), 25 were primary open-angle glaucoma (POAG), and 16 were glaucoma suspects. All the participants had a computerised Humphrey visual field (HVF) assessment and optical coherence tomography (OCT) scan and were administered the written Montreal Cognitive Assessment (MoCA) test. RGC count estimates were derived based on established formulas using the HVF and OCT results. A MoCA cut-off score of 25 and less was designated as cognitive impairment. Student’s t-test was used to assess differences between the groups. The Pearson correlation coefficient was used to assess the association between MoCA scores and retinal structural and functional measures. Results: Significant associations were found between MoCA scores and the false-negative and pattern standard deviation indices recorded on the HVF (r = −0.19, r = −0.22, p &lt; 0.05). The mean IOP was significantly lower in the cognitively impaired group (i.e., MOCA ≤ 25) (13.7 ± 3.6 vs. 15.7 ± 4.5, p &lt; 0.05). No significant association was found between RGC count estimates and MoCA scores. Analysis of these parameters in individual glaucoma subtypes did not reveal any group-specific significant associations either.</jats:p

Pressure dependency of retinal arterial pulse wave velocity in the rat

© 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V. This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/). Purpose: The retinal vasculature provides unique in vivo access to the microcirculation and presents the possibility of measuring small artery (retinal) stiffness using pulse wave velocity (PWV). This study investigates whether retinal artery PWV (rPWV) has a blood pressure (BP) dependency. Methods: Fundus videos from eight Sprague-Dawley rats aged 12 weeks were captured (Zeiss fundus microscope with high-speed camera, 125 fps, Optronis, Germany) simultaneously with aortic BP. Retinal artery diameter waveforms at proximal and distal sites were extracted and transit time calculated from the phase delay between frequency components (4–6 Hz, typical heart rate of rats) of the waveforms. rPWV was measured across a physiological range of mean arterial pressure (MAP): baseline (90–110 mmHg); 130 mmHg to baseline following systemic phenylephrine (PE) infusion (30 mg/kg/min); 130 mmHg to baseline during PE infusion with simultaneous inferior vena cava occlusion (VO); 70 mmHg to baseline following systemic sodium nitroprusside infusion; and 70 mmHg to baseline following VO. The correlation between retinal artery rPWV and BP was quantified. Results: There was a significant positive correlation between retinal artery rPWV and MAP as expected (0.19 mm/s/mmHg, R2 = 0.59, p < 0.001). There was a positive correlation between retinal and aortic PWV (R2 = 0.09, p = 0.03). Conclusion: The pressure dependency of the measured rPWV indicates the measure has utility in in vivo quantification of the impact on microvessels of cardiovascular diseases. To elucidate the predictive value of screening rPWV in systemic cardiovascular abnormalities, the relation needs to be investigated in humans

Minimising retinal vessel artefacts in optical coherence tomography images

Optical coherence tomography (OCT) is commonly used to investigate the layers of the retina including retinal nerve fiber layer (RNFL) and retinal pigment epithelium (RPE). OCT images are altered by vessels on the retinal surface producing artefacts. We propose a new approach to compensate for these artefacts and enhance quality of OCT images. A total of 28 (20 normal and 8 glaucoma subjects) OCT images were obtained using Spectralis (Heidelberg, Germany). Shadows were detected along the image and compensated by the A-Scan intensity difference from surrounding non-affected areas. Images were then segmented and the area and thickness of RNFL and RPE were measured and compared. 10 subjects were tested twice to determine the effect of this on reproducibility of measurements. Shadow-suppressed images reflected the profile of the retinal layers more closely when assessed qualitatively, minimising distortion. The segmentation of RNFL and RPE thickness demonstrated a mean change of 2.4% ± 1 and 6% ± 1 from the original images. Much larger changes were observed in areas with vessels. Reproducibility of RNFL thickness was improved, specifically in the higher density vessel location, i.e. inferior and superior. Therefore, OCT images can be enhanced by an image processing procedure. Vessel artefacts may cause errors in assessment of RNFL thickness and are a source of variability, which has clinical implications for diseases such as glaucoma where subtle changes in RNFL need to be monitored accurately over time. © 2011 Elsevier Ireland Ltd