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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-04-2020 | Angiography | Review Article

Optical coherence tomography angiography-derived flow density: a review of the influencing factors

Authors: Viktoria C. Brücher, Jens J. Storp, Nicole Eter, Maged Alnawaiseh

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 4/2020

Abstract

Research interest in the possibility of quantifying macular and optic nerve head perfusion through optical coherence tomography angiography (OCTA) is rapidly advancing. Numerous scientific trials have furthered our understanding of the capabilities and the limitations of this novel technology, while applying OCTA to various ocular pathologies. In recent years, different parameters such as age, gender, intraocular pressure, spherical equivalent, physical activity, systemic diseases, and medication have been shown to have a significant impact on quantitative OCTA metrics. Since OCTA is likely to remain a “hot topic” in the near future, it is crucial to be aware of influencing factors in order to ensure correct interpretation of imaging results. This article reviews the factors currently known to influence flow density (FD) as measured by OCTA in healthy eyes.

Spaide RF, Klancnik JM, Cooney MJ (2015) Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol 133(1):45–50. https://doi.org/10.1001/jamaophthalmol.2014.3616CrossRefPubMed

Kim DY, Fingler J, Zawadzki RJ et al (2013) Optical imaging of the chorioretinal vasculature in the living human eye. Proc Natl Acad Sci 110:14354–14359CrossRefPubMedPubMedCentral

Schwartz DM, Fingler J, Kim DY et al (2014) Phase-variance optical coherence tomography: a technique for noninvasive angiography. Ophthalmology 121:180–187. https://doi.org/10.1016/j.ophtha.2013.09.002CrossRefPubMed

Tan ACS, Tan GS, Denniston AK et al (2018) An overview of the clinical applications of optical coherence tomography angiography. Eye (Lond) 32(2):262–286. https://doi.org/10.1038/eye.2017.181CrossRef

Spaide RF, Fujimoto JG, Waheed NK, Sadda SR, Staurenghi G (2018) Optical coherence tomography angiography. Prog Retin Eye Res 64:1–55. https://doi.org/10.1016/j.preteyeres.2017.11.003CrossRefPubMed

Alnawaiseh M, Brand C, Bormann E, Sauerland C, Eter N (2018) Quantification of macular perfusion using optical coherence tomography angiography: repeatability and impact of an eye-tracking system. BMC Ophthalmol 18(1):123. https://doi.org/10.1186/s12886-018-0789-zCrossRefPubMedPubMedCentral

Lee MW, Kim KM, Lim HB, Jo YJ, Kim JY (2018) Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2018-312516

Manalastas PIC, Zangwill LM, Saunders LJ et al (2017) Reproducibility of optical coherence tomography angiography macular and optic nerve head vascular density in glaucoma and healthy eyes. J Glaucoma 26(10):851–885. https://doi.org/10.1097/IJG.0000000000000768CrossRefPubMedPubMedCentral

Quaranta-El Maftouhi M, El Maftouhi A, Eandi CM (2015) Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol 160:581–587. https://doi.org/10.1016/j.ajo.2015.06.016CrossRefPubMed

10.

Jia Y, Bailey ST, Wilson DJ et al (2014) Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration. Ophthalmology 121:1435–1444. https://doi.org/10.1016/j.ophtha.2014.01.034CrossRefPubMed

11.

Powner MB, Sim DA, Zhu M et al (2016) Evaluation of nonperfused retinal vessels in ischemic retinopathy. Invest Ophthalmol Vis Sci 57:5031–5037. https://doi.org/10.1167/iovs.16-20007CrossRefPubMed

12.

Ishibazawa A, Nagaoka T, Takahashi A et al (2015) Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study. Am J Ophthalmol 160, 35:–44.e1. https://doi.org/10.1016/j.ajo.2015.04.021

13.

Müller VC, Storp JJ, Kerschke L, Nelis P, Eter N, Alnawaiseh M (2019) Diurnal variations in flow density measured using optical coherence tomography angiography and the impact of heart rate, mean arterial pressure and intraocular pressure on flow density in primary open-angle glaucoma patients. Acta Ophthalmol. https://doi.org/10.1111/aos.14089

14.

Alnawaiseh M, Müller V, Lahme L, Merté RL, Eter N (2018) Changes in flow density measured using optical coherence tomography angiography after iStent insertion in combination with phacoemulsification in patients with open-angle glaucoma. J Ophthalmol 2018:2890357. https://doi.org/10.1155/2018/2890357CrossRefPubMedPubMedCentral

15.

Coscas F, Sellam A, Glacet-Bernard A, Jung C, Goudot M, Miere A, Souied EH (2016) Normative data for vascular density in superficial and deep capillary plexuses of healthy adults assessed by optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57(9):OCT211–OCT223. https://doi.org/10.1167/iovs.15-18793CrossRefPubMed

16.

Berrones D, Salcedo-Villanueva G, Morales-Cantón V, Velez-Montoya R (2017) Changes in retinal and choroidal vascular blood flow after oral sildenafil: an optical coherence tomography angiography study. J Ophthalmol 2017:7174540. https://doi.org/10.1155/2017/7174540CrossRefPubMedPubMedCentral

17.

Cohen SY, Miere A, Nghiem-Buffet S, Fajnkuchen F, Souied EH, Mrejen S (2018) Clinical applications of optical coherence tomography angiography: what we have learnt in the first 3 years. Eur J Ophthalmol 28(5):491–502. https://doi.org/10.1177/1120672117753704CrossRefPubMed

18.

Kashani AH, Chen CL, Gahm JK et al (2017) Optical coherence tomography angiography: a comprehensive review of current methods and clinical applications. Prog Retin Eye Res 60:66–100. https://doi.org/10.1016/j.preteyeres.2017.07.002CrossRefPubMedPubMedCentral

19.

Alnawaiseh M, Lahme L, Eter N, Mardin C Optical coherence tomography angiography: value for glaucoma diagnostics. Ophthalmologe. https://doi.org/10.1007/s00347-018-0815-9

20.

Alnawaiseh M, Ertmer C, Seidel L et al (2018) Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock. Crit Care 22(1):138. https://doi.org/10.1186/s13054-018-2056-3CrossRefPubMedPubMedCentral

21.

Alnawaiseh M, Schubert F, Heiduschka P, Eter N (2017) Optical coherence tomography angiography in patients with retinitis pigmentosa. Retina. https://doi.org/10.1097/IAE.0000000000001904

22.

Nelis P, Kleffner I, Burg MC et al (2018) OCT—angiography reveals reduced vessel density in the deep retinal plexus of CADASIL patients. Sci Rep 8(1):8148. https://doi.org/10.1038/s41598-018-26475-5CrossRefPubMedPubMedCentral

23.

Alnawaiseh M, Rosentreter A, Hillmann A et al (2016) OCT angiography in the mouse: a novel evaluation method for vascular pathologies of the mouse retina. Exp Eye Res 145:417–423. https://doi.org/10.1016/j.exer.2016.02.012CrossRefPubMed

24.

Brand C, Zitzmann M, Eter N, Kliesch S, Wistuba J, Alnawaiseh M, Heiduschka P (2017) Aberrant ocular architecture and function in patients with Klinefelter syndrome. Sci Rep 7(1):13130. https://doi.org/10.1038/s41598-017-13528-4CrossRefPubMedPubMedCentral

25.

Treder M, Lauermann JL, Alnawaiseh M, Heiduschka P, Eter N (2018) Quantitative changes in flow density in patients with adult-onset foveomacular vitelliform dystrophy: an OCT angiography study. Graefes Arch Clin Exp Ophthalmol 256(1):23–28. https://doi.org/10.1007/s00417-017-3815-6CrossRefPubMed

26.

Alnawaiseh M, Lahme L, Treder M, Rosentreter A, Eter N (2017) Short-term effects of exercise on optic nerve and macular perfusion measured by optical coherence tomography angiography. Retina 37(9):1642–1646. https://doi.org/10.1097/IAE.0000000000001419CrossRefPubMed

27.

Alnawaiseh M, Schubert F, Nelis P, Wirths G, Rosentreter A, Eter N (2016) Optical coherence tomography (OCT) angiography findings in retinal arterial macroaneurysms. BMC Ophthalmol 16:120. https://doi.org/10.1186/s12886-016-0293-2CrossRefPubMedPubMedCentral

28.

Al-Sheikh M, Phasukkijwatana N, Dolz-Marco R et al (2017) OCT angiography of the retinal microvasculature and the choriocapillaris in myopic eyes. Invest Ophthalmol Vis Sci 58(4):2063–2069. https://doi.org/10.1167/iovs.16-21289CrossRefPubMed

29.

Suwan Y, Fard MA, Geyman LS, Tantraworasin A, Chui TY, Rosen RB, Ritch R (2018) Association of myopia with peripapillary perfused capillary density in patients with glaucoma: an optical coherence tomography angiography study. JAMA Ophthalmol 136(5):507–513. https://doi.org/10.1001/jamaophthalmol.2018.0776CrossRefPubMedPubMedCentral

30.

Hassan M, Sadiq MA, Halim MS et al (2017) Evaluation of macular and peripapillary vessel flow density in eyes with no known pathology using optical coherence tomography angiography. Int J Retina Vitreous 3:27. https://doi.org/10.1186/s40942-017-0080-0CrossRefPubMedPubMedCentral

31.

Li M, Yang Y, Jiang H et al (2017) Retinal microvascular network and microcirculation assessments in high myopia. Am J Ophthalmol 174:56–67. https://doi.org/10.1016/j.ajo.2016.10.018CrossRefPubMed

32.

Milani P, Montesano G, Rossetti L, Bergamini F, Pece A (2018) Vessel density, retinal thickness, and choriocapillaris vascular flow in myopic eyes on OCT angiography. Graefes Arch Clin Exp Ophthalmol 256(8):1419–1427. https://doi.org/10.1007/s00417-018-4012-yCrossRefPubMed

33.

Leng Y, Tam EK, Falavarjani KG, Tsui I (2018) Effect of age and myopia on retinal microvasculature. Ophthalmic Surg Lasers Imaging Retina 49(12):925–931. https://doi.org/10.3928/23258160-20181203-03CrossRefPubMed

34.

Cheung CY, Li J, Yuan N (2018) Quantitative retinal microvasculature in children using swept-source optical coherence tomography: the Hong Kong Children Eye Study. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2018-312413

35.

Wen C, Pei C, Xu X, Lei J (2019) Influence of axial length on parafoveal and peripapillary metrics from swept source optical coherence tomography angiography. Curr Eye Res 17:1–7. https://doi.org/10.1080/02713683.2019.1607393CrossRef

36.

Bennett AG, Rudnicka AR, Edgar DF (1994) Improvements on Littmann’s method of determining the size of retinal features by fundus photography. Graefes Arch Clin Exp Ophthalmol 232:361–367CrossRefPubMed

37.

Wang Q, Chan S, Yang JY et al (2016) Vascular density in retina and choriocapillaris as measured by optical coherence tomography angiography. Am J Ophthalmol 168:95–109. https://doi.org/10.1016/j.ajo.2016.05.005CrossRefPubMed

38.

Zhang Z, Huang X, Meng X, Chen T, Gu Y, Wu Y, Wu Z (2017) In vivo assessment of macula in eyes of healthy children 8 to 16 years old using optical coherence tomography angiography. Sci Rep. https://doi.org/10.1038/s41598-017-08174-9

39.

Falavarjani KG, Shenazandi H, Naseri D et al (2018) Foveal avascular zone and vessel density in healthy subjects: an optical coherence tomography angiography study. J Ophthalmic Vis Res 13(3):260–265. https://doi.org/10.4103/jovr.jovr_173_17CrossRefPubMedPubMedCentral

40.

Oh J, Baik DJ, Ahn J (2018) Inter-relationship between retinal and choroidal vasculatures using optical coherence tomography angiography in normal eyes. Eur J Ophthalmol. https://doi.org/10.1177/2F1120672118816225

41.

Yu J, Gu R, Zong Y et al (2016) Relationship between retinal perfusion and retinal thickness in healthy subjects: an optical coherence tomography angiography study. Invest Ophthalmol Vis Sci 57(9):OCT204–OCT210. https://doi.org/10.1167/iovs.15-18630CrossRefPubMedPubMedCentral

42.

Patel N, McAllister F, Pardon L, Harwerth R (2018) The effects of graded intraocular pressure challenge on the optic nerve head. Exp Eye Res 169:79–90. https://doi.org/10.1016/j.exer.2018.01.025CrossRefPubMedPubMedCentral

43.

Zhang Q, Jonas JB, Wang Q, Chan SY, Xu L, Wei WB, Wang YX (2018) Optical coherence tomography angiography vessel density changes after acute intraocular pressure elevation. Sci Rep 8(1):6024. https://doi.org/10.1038/s41598-018-24520-xCrossRefPubMedPubMedCentral

44.

Mansouri K, Rao HL, Hoskens K, D’Alessandro E, Flores-Reyes EM, Mermoud A, Weinreb RN (2018) Diurnal variations of peripapillary and macular vessel density in glaucomatous eyes using optical coherence tomography angiography. J Glaucoma 27(4):336–341. https://doi.org/10.1097/IJG.0000000000000914CrossRefPubMed

45.

Holló G (2017) Influence of large intraocular pressure reduction on peripapillary OCT vessel density in ocular hypertensive and glaucoma eyes. J Glaucoma 26(1):e7–e10. https://doi.org/10.1097/IJG.0000000000000527CrossRefPubMed

46.

Yu S, Frueh BE, Steinmair D, Ebneter A, Wolf S, Zinkernagel MS, Munk MR (2018) Cataract significantly influences quantitative measurements on swept-source optical coherence tomography angiography imaging. PLoS One 13(10):e0204501. https://doi.org/10.1371/journal.pone.0204501CrossRefPubMedPubMedCentral

47.

Tan CS, Lim LW, Ting DS (2018) Changes in retinal vasculature after phacoemulsification evaluated using optical coherence tomography angiography. J Cataract Refract Surg 44(10):1297–1298. https://doi.org/10.1016/j.jcrs.2018.07.014CrossRefPubMed

48.

Zhao Z, Wen W, Jiang C, Lu Y (2018) Changes in macular vasculature after uncomplicated phacoemulsification surgery: optical coherence tomography angiography study. J Cataract Refract Surg 44(4):453–458. https://doi.org/10.1016/j.jcrs.2018.02.014CrossRefPubMed

49.

Kaur S, Singh SR, Sukhija J, Dogra MR (2018) Comparison of quantitative measurement of foveal avascular zone and macular vessel density in eyes of children with amblyopia and healthy controls: an optical coherence tomography angiography study. J AAPOS 22(2):164–165. https://doi.org/10.1016/j.jaapos.2017.06.026CrossRefPubMed

50.

Guo L, Tao J, Xia F, Yang Z, Ma X, Hua R (2016) In vivo optical imaging of amblyopia: digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography. Lasers Surg Med 48(7):660–667. https://doi.org/10.1002/lsm.22520CrossRefPubMed

51.

Yilmaz I, Ocak OB, Yilmaz BS, Inal A, Gokyigit B, Taskapili M (2017) Comparison of quantitative measurement of foveal avascular zone and macular vessel density in eyes of children with amblyopia and healthy controls: an optical coherence tomography angiography study. J AAPOS 21(3):224–228. https://doi.org/10.1016/j.jaapos.2017.05.002CrossRefPubMed

52.

Sobral I, Rodrigues TM, Soares M, Seara M, Monteiro M, Paiva C, Castela R (2018) OCT angiography findings in children with amblyopia. J AAPOS 22(4):286–289.e2. https://doi.org/10.1016/j.jaapos.2018.03.009CrossRefPubMed

53.

Lonngi M, Velez FG, Tsui I et al (2017) Spectral-domain optical coherence tomographic angiography in children with amblyopia. JAMA Ophthalmol 135(10):1086–1091. https://doi.org/10.1001/jamaophthalmol.2017.3423CrossRefPubMedPubMedCentral

54.

Demirayak B, Vural A, Onur IU, Kaya FS, Yigit FU (2018) Analysis of macular vessel density and foveal avascular zone using spectral-domain optical coherence tomography angiography in children with amblyopia. J Pediatr Ophthalmol Strabismus 56(1):55–59. https://doi.org/10.3928/01913913-20181003-02CrossRefPubMed

55.

Borrelli E, Lonngi M, Balasubramanian S et al (2018) Increased choriocapillaris vessel density in amblyopic children: a case-control study. J AAPOS 22(5):366–370. https://doi.org/10.1016/j.jaapos.2018.04.005CrossRefPubMed

56.

Lim HB, Kim YW, Kim JM, Jo YJ, Kim JY (2018) The importance of signal strength in quantitative assessment of retinal vessel density using optical coherence tomography angiography. Sci Rep 8:12897. https://doi.org/10.1038/s41598-018-31321-9CrossRefPubMedPubMedCentral

57.

Ravalico G, Toffoli G, Pastori G, Crocè M, Calderini S (1996) Age-related ocular blood flow changes. Invest Ophthalmol Vis Sci 37(13):2645–2650PubMed

58.

Alnawaiseh M, Brand C, Lauermann JL, Eter N (2018) Flow density measurements using optical coherence tomography angiography: Impact of age and gender. Ophthalmologe 115(8):659–662. https://doi.org/10.1007/s00347-017-0539-2CrossRefPubMed

59.

Nassisi M, Baghdasaryan E, Tepelus T, Asanad S, Borrelli E, Sadda SR (2018) Topographic distribution of choriocapillaris flow deficits in healthy eyes. PLoS One 13(11):e0207638. https://doi.org/10.1371/journal.pone.0207638CrossRefPubMedPubMedCentral

60.

Sacconi R, Borrelli E, Corbelli E et al (2018) Quantitative changes in the ageing choriocapillaris as measured by swept source optical coherence tomography angiography. Br J Ophthalmol. https://doi.org/10.1136/bjophthalmol-2018-313004

61.

Iafe NA, Phasukkijwatana N, Chen X, Sarraf D (2016) Retinal capillary density and foveal avascular zone area are age-dependent: quantitative analysis using optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57(13):5780–5787. https://doi.org/10.1167/iovs.16-20045CrossRefPubMed

62.

Pinhas A, Linderman R, Mo S et al (2018) A method for age-matched OCT angiography deviation mapping in the assessment of disease- related changes to the radial peripapillary capillaries. PloS One 13(5):e0197062. https://doi.org/10.1371/journal.pone.0197062CrossRefPubMedPubMedCentral

63.

Shahlaee A, Samara WA, Hsu J et al (2016) In vivo assessment of macular vascular density in healthy human eyes using optical coherence tomography angiography. Am J Ophthalmol 165:39–46. https://doi.org/10.1016/j.ajo.2016.02.018CrossRefPubMed

64.

Wei Y, Jiang H, Shi Y et al (2017) Age-related alterations in the retinal microvasculature, microcirculation, and microstructure. Invest Ophthalmol Vis Sci 58(9):3804–3817. https://doi.org/10.1167/iovs.17-21460CrossRefPubMedPubMedCentral

65.

Rao HL, Pradhan ZS, Weinreb RN et al (2017) Determinants of peripapillary and macular vessel densities measured by optical coherence tomography angiography in normal eyes. J Glaucoma 26(5):491–497. https://doi.org/10.1097/IJG.0000000000000655CrossRefPubMed

66.

Lavia C, Bonnin S, Maule M, Erginay A, Tadayoni R, Gaudric A (2018) Vessel density of superficial, intermediate, and deep capillary plexuses using optical coherence tomography angiography. Retina 39(2):247–258. https://doi.org/10.1097/IAE.0000000000002413CrossRefPubMedCentral

67.

Bazvand F, Mirshahi R, Fadakar K, Faghihi H, Sabour S, Ghassemi F (2017) The quantitative measurements of vascular density and flow area of optic nerve head using optical coherence tomography angiography. J Glaucoma 26(8):735–741. https://doi.org/10.1097/IJG.0000000000000722CrossRefPubMed

68.

Yu J, Jiang C, Wang X et al (2015) Macular perfusion in healthy Chinese: an optical coherence tomography angiogram study. Invest Ophthalmol Vis Sci 56(5):3212–3217. https://doi.org/10.1167/iovs.14-16270CrossRefPubMedPubMedCentral

69.

Gadde SG, Anegondi N, Bhanushali D, Chidambar L, Yadav NK, Khurana A, Sinha Roy A (2016) Quantification of vessel density in retinal optical coherence tomography angiography images using local fractal dimension. Invest Ophthalmol Vis Sci 57(1):246–252. https://doi.org/10.1167/iovs.15-18287CrossRefPubMed

70.

Zhou M, Lu B, Zhang P, Zhao J, Wang Q, Sun X (2017) Determination of topographic variations in inner retinal blood flow areas in young Chinese subjects using optical coherence tomography angiography. Curr Eye Res 42(11):149. https://doi.org/10.1080/02713683.2016.1266662CrossRef

71.

Schmitz B, Nelis P, Rolfes F et al (2018) Effects of high-intensity interval training on optic nerve head and macular perfusion using optical coherence tomography angiography in healthy adults. Atherosclerosis 274:8–15. https://doi.org/10.1016/j.atherosclerosis.2018.04.028CrossRefPubMed

72.

Ayhan Z, Kaya M, Ozturk T, Karti O, Hakan Oner F (2017) Evaluation of macular perfusion in healthy smokers by using optical coherence tomography angiography. Ophthalmic Surg Lasers Imaging Retina 48(8):617–622. https://doi.org/10.3928/23258160-20170802-03CrossRefPubMed

73.

Holló G (2018) No acute effect of smoking on peripapillary and macular vessel density in healthy middle-aged smokers. J Glaucoma. https://doi.org/10.1097/IJG.0000000000001171

74.

Karti O, Zengin MO, Kerci SG, Ayhan Z, Kusbeci T (2018) Acute effect of caffeine on macular microcirculation in healthy subjects: an optical coherence tomography angiography study. Retina. https://doi.org/10.1097/IAE.0000000000002058

75.

Serafini S, Lohmann CP, Ulbig M (2019) A young patient with full visual acuity, small visual field defects, and normal fluorescence angiogram. Ophthalmologe 116:176. https://doi.org/10.1007/s00347-018-0733-xCrossRefPubMed

76.

Goker YS, Ucgul Atılgan C, Tekin K (2019) The validity of optical coherence tomography angiography as a screening test for the early detection of retinal changes in patients with hydroxychloroquine therapy. Curr Eye Res 44(3):311–315. https://doi.org/10.1080/02713683.2018.1545912CrossRefPubMed

77.

Ozek D, Onen M, Karaca EE, Omma A, Kemer OE, Coskun C (2018) The optical coherence tomography angiography findings of rheumatoid arthritis patients taking hydroxychloroquine. Eur J Ophthalmol 19:1120672118801125. https://doi.org/10.1177/1120672118801125CrossRef

78.

Bulut M, Akıdan M, Gözkaya O, Erol MK, Cengiz A, Çay HF (2018) Optical coherence tomography angiography for screening of hydroxychloroquine-induced retinal alterations. Graefes Arch Clin Exp Ophthalmol 256(11):2075–2081. https://doi.org/10.1007/s00417-018-4117-3CrossRefPubMed

79.

Glossmann H, Petrischor G, Bartsch G (1999) Molecular mechanisms of the effects of sildenafil (VIAGRA®). Exp Gerontol 34(3):305–318. https://doi.org/10.1016/s0531-5565(99)00003-0CrossRefPubMed

80.

Chihara E, Dimitrova G, Chihara T (2018) Increase in the OCT angiographic peripapillary vessel density by ROCK inhibitor ripasudil instillation: a comparison with brimonidine. Graefes Arch Clin Exp Ophthalmol 256(7):1257–1264. https://doi.org/10.1007/s00417-018-3945-5CrossRefPubMedPubMedCentral

81.

Cheng J, Yu J, Jiang C, Sun X (2017) Phenylephrine affects peripapillary retinal vasculature—an optic coherence tomography angiography study. Front Physiol 4:8–996. https://doi.org/10.3389/fphys.2017.00996CrossRef

82.

Zong Y, Xu H, Yu J, Jiang C, Kong X, He Y, Sun X (2017) Retinal vascular autoregulation during phase IV of the Valsalva maneuver: an optical coherence tomography angiography study in healthy Chinese adults. Front Physiol 8:553. https://doi.org/10.3389/fphys.2017.00553CrossRefPubMedPubMedCentral

83.

Chua J, Chin CWL, Hong J et al (2019) Impact of hypertension on retinal capillary microvasculature using optical coherence tomographic angiography. J Hypertens 37(3):572–580. https://doi.org/10.1097/HJH.0000000000001916CrossRefPubMed

84.

Rotsos T, Andreanos K, Blounas S, Brouzas D, Ladas DS, Ladas ID (2017) Multimodal imaging of hypertensive chorioretinopathy by swept-source optical coherence tomography and optical coherence tomography angiography: case report. Medicine (Baltimore) 96(39):e8110. https://doi.org/10.1097/MD.0000000000008110CrossRef

85.

Lim HB, Lee MW, Park JH, Kim KM, Jo YJ, Kim JY (2019) Changes in ganglion cell-inner plexiform layer thickness and retinal microvasculature in hypertension: an OCT angiography study. Am J Ophthalmol 119:167–176. https://doi.org/10.1016/j.ajo.2018.11.016CrossRef

86.

Arnould L, Guenancia C, Azemar A et al (2018) The EYE-MI pilot study: a prospective acute coronary syndrome cohort evaluated with retinal optical coherence tomography angiography. Invest Ophthalmol Vis Sci 59(10):4299–4306. https://doi.org/10.1167/iovs.18-24090CrossRefPubMed

87.

Takayama K, Kaneko H, Ito Y et al (2018) Novel classification of early-stage systemic hypertensive changes in human retina based on OCTA measurement of choriocapillaris. Sci Rep 8(1):15163. https://doi.org/10.1038/s41598-018-33580-yCrossRefPubMedPubMedCentral

88.

Saito M, Ishibazawa A, Kinouchi R, Yoshida A (2018) Reperfusion of the choriocapillaris observed using optical coherence tomography angiography in hypertensive choroidopathy. Int Ophthalmol 38(5):2205–2210. https://doi.org/10.1007/s10792-017-0705-1CrossRefPubMed

89.

Nesper PL, Simjanoski E, Mirza RG (2016) Retinal macroaneurysm in long-standing hypertension. Opthalmology 123(11):2327. https://doi.org/10.1016/j.ophtha.2016.05.024CrossRef

90.

Spaide (2016) Choriocapillaris flow features follow a power law distribution: implications for characterization and mechanisms of disease progression. Am J Ophthalmol 170:58–67. https://doi.org/10.1016/j.ajo.2016.07.023

91.

Lahme L, Marchiori E, Panuccio G et al (2018) Changes in retinal flow density measured by optical coherence tomography angiography in patients with carotid artery stenosis after carotid endarterectomy. Sci Rep 8(1):17161. https://doi.org/10.1038/s41598-018-35556-4CrossRefPubMedPubMedCentral

92.

Pechauer AD, Jia Y, Liu L, Gao SS, Jiang C, Huang D (2015) Optical coherence tomography angiography of peripapillary retinal blood flow response to hyperoxia. Invest Ophthalmol Vis Sci 56(5):3287–3291. https://doi.org/10.1167/iovs.15-16655CrossRefPubMedPubMedCentral

93.

Xu H, Deng G, Jiang C, Kong X, Yu J, Sun X (2016) Microcirculatory responses to hyperoxia in macular and peripapillary regions. Invest Ophthalmol Vis Sci 57(10):4464–4468. https://doi.org/10.1167/iovs.16-19603CrossRefPubMed

94.

Hagag AM, Pechauer AD, Liu L, Wang J, Zhang M, Jia Y, Huang D (2018) OCT angiography changes in the 3 parafoveal retinal plexuses in response to hyperoxia. Ophthalmol Retina 2(4):329–336. https://doi.org/10.1016/j.oret.2017.07.022CrossRefPubMed

95.

White DP (1995) Sleep-related breathing disorder.2. Pathophysiology of obstructive sleep apnoea. Thorax 50(7):797–804CrossRefPubMedPubMedCentral

96.

Nieto FJ, Young TB, Lind BK et al (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 283(14):1829–1836. https://doi.org/. https://doi.org/10.1001/jama.283.14.1829CrossRefPubMed

97.

Shahar E, Whitney CW, Redline S et al (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163(1):19–25. https://doi.org/10.1164/ajrccm.163.1.2001008CrossRefPubMed

98.

Yu J, Xiao K, Huang J, Sun X, Jiang C (2017) Reduced retinal vessel density in obstructive sleep apnea syndrome patients: an optical coherence tomography angiography study. Invest Ophthalmol Vis Sci 58(9):3506–3512. https://doi.org/10.1167/iovs.17-21414CrossRefPubMed

99.

Palombi K, Renard E, Levy P, Chiquet C, Deschaux C, Romanet JP, Pépin JL (2006) Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea. Br J Ophthalmol 90(7):879–882. https://doi.org/10.1136/2Fbjo.2005.087452CrossRefPubMedPubMedCentral

100.

Chou KT, Huang CC, Tsai DC et al (2012) Sleep apnea and risk of retinal vein occlusion: a nationwide population-based study of Taiwanese. Am J Ophthalmol 154(1):200–205.e1. https://doi.org/10.1016/j.ajo.2012.01.011CrossRefPubMed

101.

Li DQ, Golding J, Choudhry N (2016) Findings in obstructive sleep apnea. Ophthalmic Surg Lasers Imaging Retina 47(9):880–884. https://doi.org/10.3928/23258160-20160901-14CrossRefPubMed

102.

Moyal L, Blumen-Ohana E, Blumen M, Blatrix C, Chabolle F, Nordmann JP (2018) Parafoveal and optic disc vessel density in patients with obstructive sleep apnea syndrome: an optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol 256(7):1235–1243. https://doi.org/10.1007/s00417-018-3943-7CrossRefPubMed

103.

Wang XY, Li M, Ding X, Han DM (2017) Application of optical coherence tomography angiography in evaluation of retinal microvascular changes in patients with obstructive sleep apnea syndrome. Zhonghua Yi Xue Za Zhi 97(32):2501–2505. https://doi.org/10.3760/cma.j.issn.0376-2491.2017.32.006CrossRefPubMed

104.

Ye H, Zheng C, Lan X, Zhao L, Qiao T, Li X, Zhang Y (2019) Evaluation of retinal vasculature before and after treatment of children with obstructive sleep apnea-hypopnea syndrome by optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 257(3):543–548. https://doi.org/10.1007/s00417-018-04207-9CrossRefPubMed

105.

Lahme L, Esser EL, Mihailovic N et al (2018) Evaluation of ocular perfusion in Alzheimer’s disease using optical coherence tomography angiography. J Alzheimers Dis 66(4):1745–1752. https://doi.org/10.3233/JAD-180738CrossRefPubMed

106.

Bulut M, Kurtuluş F, Gözkaya O, Erol MK, Cengiz A, Akidan M, Yaman A (2018) Evaluation of optical coherence tomography angiographic findings in Alzheimer’s type dementia. Br J Ophthalmol 102(2):233–237. https://doi.org/10.1136/bjophthalmol-2017-310476CrossRefPubMed

107.

Li Y, Choi WJ, Wei W, Song S, Zhang Q, Liu J, Wang RK (2018) Aging-associated changes in cerebral vasculature and blood flow as determined by quantitative optical coherence tomography angiography. Neurobiol Aging 70:148–159. https://doi.org/10.1016/j.neurobiolaging.2018.06.017CrossRefPubMedPubMedCentral

108.

Kwapong WR, Ye H, Peng C, Zhuang X, Wang J, Shen M, Lu F (2018) Retinal microvascular impairment in the early stages of Parkinson’s disease. Invest Ophthalmol Vis Sci 59:4115–4122. https://doi.org/10.1167/iovs.17-23230CrossRefPubMed

109.

Miri S, Shrier EM, Glazman S, Ding Y, Selesnick I, Kozlowski PB, Bodis-Wollner I (2015) The avascular zone and neuronal remodelling of the fovea in Parkinson disease. Ann Clin Transl Neurol 2:196–201. https://doi.org/10.1002/acn3.146CrossRefPubMedPubMedCentral

110.

Feucht N, Maier M, Lepennetier G et al (2019) Optical coherence tomography angiography indicates associations of the retinal vascular network and disease activity in multiple sclerosis. Mult Scler 25(2):224–234. https://doi.org/10.1177/2F1352458517750009CrossRefPubMed

111.

Lanzillo R, Cennamo G, Criscuolo C et al (2017) Optical coherence tomography angiography retinal vascular network assessment in multiple sclerosis. Mult Scler 24(13):1706–1714. https://doi.org/10.1177/1352458517729463CrossRefPubMed

112.

Spain RI, Liu L, Zhang X et al (2017) OCT angiography enhances the detection of optic nerve damage in multiple sclerosis. Br J Ophthalmol 102(4):520–524. https://doi.org/10.1136/bjophthalmol-2017-310477CrossRefPubMed

113.

Wang X, Jia Y, Spain R et al (2014) Optical coherence tomography angiography of optic nerve head and parafovea in multiple sclerosis. Br J Ophthamol 98:1368–1373. https://doi.org/10.1136/bjophthalmol-2013-304547CrossRef

114.

Conigliaro P, Cesareo M, Chimenti MS et al (2019) Evaluation of retinal microvascular density in patients affected by systemic lupus erythematosus: an optical coherence tomography angiography study. Ann Rheum Dis 78(2):287–289. https://doi.org/10.1136/annrheumdis-2018-214235CrossRefPubMed

115.

Goker S, Yilmaz S, Kiziltoprak H, Tekin K, Demir G (2019) Quantitative analysis of optical coherence tomography angiography features in patients with nonocular Behcet’s disease. Curr Eye Res 44(2):212–218. https://doi.org/10.1080/02713683.2018.1530361CrossRefPubMed

116.

Rothe M, Rommel F, Klapa S et al (2019) Evaluation of retinal microvascular perfusion in systemic sclerosis: a case-control study. Ann Rheum Dis. https://doi.org/10.1136/annrheumdis-2018-214541

Title: Optical coherence tomography angiography-derived flow density: a review of the influencing factors
Authors: Viktoria C. Brücher
Jens J. Storp
Nicole Eter
Maged Alnawaiseh
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keyword: Angiography
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 4/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-019-04553-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Optical coherence tomography angiography-derived flow density: a review of the influencing factors

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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