Towards standardizing retinal optical coherence tomography angiography: a review

Light Science & Applications, Journal Year: 2022, Volume and Issue: 11(1)

Published: March 18, 2022

Abstract The visualization and assessment of retinal microvasculature are important in the study, diagnosis, monitoring, guidance treatment ocular systemic diseases. With introduction optical coherence tomography angiography (OCTA), it has become possible to visualize volumetrically without a contrast agent. Many lab-based commercial clinical instruments, imaging protocols data analysis methods metrics, have been applied, often inconsistently, resulting confusing picture that represents major barrier progress applying OCTA reduce burden disease. Open software sharing, cross-comparison pooling from different studies rare. These inabilities impeded building large databases annotated images healthy diseased retinas necessary study define characteristics specific conditions. This paper addresses steps needed standardize human retina address these limitations. Through review literature, we identify issues inconsistencies propose minimum standards for protocols, methods, reporting findings, practice and, where this is not possible, areas require further investigation. We hope will encourage unification OCTA, promote transparency process collection, analysis, reporting, facilitate increasing impact on healthcare delivery life science investigations.

Language: Английский

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Impact of Arterial Hypertension on the Eye: A Review of the Pathogenesis, Diagnostic Methods, and Treatment of Hypertensive Retinopathy

Medical Science Monitor, Journal Year: 2022, Volume and Issue: 28

Published: Jan. 7, 2022

The number of patients with arterial hypertension is continually increasing. Hypertension can cause organ complications, called hypertension-mediated damage (HMOD). One example hypertensive retinopathy, in which high blood pressure (BP) damages both the retinal microcirculation and nerve fiber layer (RNFL). This result progressive painless vision deterioration some groups patients. Unlike anywhere else human body, microvasculature retina be observed vivo, progression changes closely monitored. harmful effect increased BP on eye not only limited to but also lead an exacerbation diabetic retinopathy (DR) increase intraocular (IOP), it trigger formation thromboembolic lesions.This review presents update pathogenesis use adaptive optics (AO) combined optical coherence tomography (OCT) evaluate microvasculature. latest progress directions research field are discussed.

Language: Английский

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Synthetic Optical Coherence Tomography Angiographs for Detailed Retinal Vessel Segmentation Without Human Annotations

IEEE Transactions on Medical Imaging, Journal Year: 2024, Volume and Issue: 43(6), P. 2061 - 2073

Published: Jan. 15, 2024

Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality that can acquire high-resolution volumes of the retinal vasculature and aid diagnosis ocular, neurological cardiac diseases. Segmenting visible blood vessels common first step when extracting quantitative biomarkers from these images. Classical segmentation algorithms based on thresholding are strongly affected by image artifacts limited signal-to-noise ratio. The use modern, deep learning-based methods has been inhibited lack large datasets with detailed annotations vessels. To address this issue, recent work employed transfer learning, where network trained synthetic OCTA images then applied to real data. However, previously proposed simulations fail faithfully model do not provide effective domain adaptation. Because this, current unable fully segment vasculature, in particular smallest capillaries. In work, we present lightweight simulation vascular space colonization for faster more realistic synthesis. We introduce three contrast adaptation pipelines decrease gap between artificial demonstrate superior performance our approach extensive qualitative experiments public compare method traditional computer vision supervised training using human annotations. Finally, make entire pipeline publicly available, including source code, pretrained models, dataset

Language: Английский

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The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons

Kidney International, Journal Year: 2020, Volume and Issue: 98(2), P. 323 - 342

Published: Feb. 27, 2020

Chronic kidney disease (CKD) is common, with hypertension and diabetes mellitus acting as major risk factors for its development. Cardiovascular the leading cause of death worldwide most frequent end point CKD. There an urgent need more precise methods to identify patients at CKD cardiovascular disease. Alterations in microvascular structure function contribute development hypertension, diabetes, CKD, their associated Homology between eye suggests that noninvasive imaging retinal vessels can detect these alterations improve targeting at-risk patients. Retinal vessel–derived metrics predict incident add current renal stratification tools. The advent optical coherence tomography (OCT) has transformed by capturing chorioretinal microcirculation dependent tissue near-histological resolution. In OCT revealed vessel remodeling thinning. Clinical preclinical linked pathology circulating histological markers injury kidney. angiography allows contrast-free visualization intraretinal capillary networks potentially early incipient Combining OCT’s deep analytical power learning represents next frontier defining what reveal about broader health. affects ∼10% world’s population, incidence increasing.1Gansevoort R.T. Correa-Rotter R. Hemmelgarn B.R. et al.Chronic risk: epidemiology, mechanisms, prevention.Lancet. 2013; 382: 339-352Abstract Full Text PDF PubMed Scopus (703) Google Scholar Hypertension are also common worldwide, estimated prevalence ∼30% ∼10%, respectively; both important progression CKD.2Kearney P.M. Whelton M. Reynolds K. al.Global burden hypertension: analysis data.Lancet. 2005; 365: 217-223Abstract (3983) Scholar,3Sarwar N. Gao P. Seshasai S.R. al.Diabetes mellitus, fasting blood glucose concentration, vascular disease: a collaborative meta-analysis 102 prospective studies.Lancet. 2010; 375: 2215-2222Abstract (0) These systemic diseases strongly (CVD), interrelationship contributes CVD being CKD.4Thomas B. Matsushita Abate K.H. outcomes reduced GFR.J Am Soc Nephrol. 2017; 28: 2167-2179Crossref (71) clinical tools lack precision detect, stratify, track individual increased progressive CVD, before end-organ damage. Thus, there unmet simple allow earlier identification subsequent end-stage CVD. Microvessels (luminal diameter <300 μm) regulate perfusion resistance. This ability closely endothelial function. Several pathophysiological processes may be consequence dysfunction, downstream effects on microvessels (Figure 1).5Brunner H. Cockcroft J.R. Deanfield J. al.Endothelial dysfunction. Part II: Association diseases. A statement Working Group Endothelins Endothelial Factors European Society Hypertension.J Hypertens. 23: 233-246Crossref (546) CVD.5Brunner Scholar, 6Houben A. Martens R.J.H. Stehouwer C.D.A. Assessing humans from chronic perspective.J 3461-3472Crossref (21) 7Stehouwer Microvascular dysfunction hyperglycemia: vicious cycle widespread consequences.Diabetes. 2018; 67: 1729-1741Crossref (36) Importantly, such changes precede damage8Halcox J.P. Schenke W.H. Zalos G. al.Prognostic value coronary dysfunction.Circulation. 2002; 106: 653-658Crossref (1133) appear modifiable.9Remuzzi Sangalli F. Macconi D. al.Regression angiotensin II antagonism caused regeneration vasculature.J 2016; 27: 699-705Crossref (19) Moreover, peripheral beds mirrors visceral beds,10Anderson T.J. Uehata Gerhard M.D. al.Close relation human circulations.J Coll Cardiol. 1995; 26: 1235-1241Crossref (1648) Scholar,11Bonetti P.O. Pumper G.M. Higano S.T. al.Noninvasive atherosclerosis assessment digital reactive hyperemia.J 2004; 44: 2137-2141Crossref (635) providing rationale accessible microvessels, those eye. Transparency ocular media direct microvasculature affected Here, we discuss basis act window evidence report adverse outcomes. have several structural, developmental, organizational similarities support concept tissues might reflect 2). Bruch’s membrane divides posterior pole into retina (a laminated neurovascular structure) choroid (an almost entirely structure), collectively termed chorioretinal. glomerular basement (GBM) contain network α3, α4, α5 type IV collagen chains.12Booij J.C. Baas D.C. Beisekeeva al.The dynamic nature membrane.Prog Retin Eye Res. 29: 1-18Crossref (252) Scholar,13Boutaud Borza D.-B. Bondar O. al.Type membrane.J Biol Chem. 2000; 275: 30716-30724Crossref inherited or acquired involving affect organs; presence coexistent nephropathy retinopathy Alport syndrome well-described example this (Supplementary Figure S1).14Savige Sheth S. Leys al.Ocular features Alport’s syndrome: pathogenesis significance.Clin J 2015; 10: 703-709Crossref Scholar,15Colville Savige Branley Wilson Ocular abnormalities thin disease.Br Ophthalmol. 1997; 81: 373-377Crossref As another example, anti-GBM characterized IgG autoantibodies directed against α3 chain, which deposited alveolar membranes triggering crescentic glomerulonephritis pulmonary hemorrhage, respectively.16McAdoo S.P. Pusey C.D. Anti-glomerular disease.Clin 12: 1162-1172Crossref (57) Similar linear deposition been reported who developed concurrent choroidal ischemia detachment.17Jampol L.M. Lahov Albert D.M. Craft findings Goodpasture’s syndrome.Am 1975; 79: 452-463Abstract Scholar,18Rowe P.A. Mansfield Dutton G.N. Ophthalmic fourteen cases syndrome.Nephron. 1994; 68: 52-56Crossref arrangement (choriocapillaris) endothelium, membrane, pigment epithelium GBM, podocyte pathological relevance homology readily appreciated membranoproliferative II, electron dense deposits found GBM membrane.19McAvoy C.E. Silvestri 2 glomerulonephritis.Eye. 19: 985-989Crossref (31) Evidence complement system dysregulation key driver deposit formation glomerulonephritis20Sethi Fervenza F.C. Membranoproliferative glomerulonephritis—a new look old entity.N Engl Med. 2012; 366: 1119-1131Crossref (288) drusen age-related macular degeneration extended link include immune regulation.21Whitmore S.S. Sohn E.H. Chirco K.R. al.Complement activation choriocapillaris loss AMD: implications pathophysiology therapy.Prog 45: 1-29Crossref (83) Scholar,22Dalvin L.A. Sethi Pulido J.S. Manifestations complement-mediated complex-mediated glomerulonephritis: comparative consecutive series.Ophthalmology. 123: 1588-1594Abstract (8) circulation develops predominantly angiogenesis, where bud preexisting ones, supply inner two-thirds retina.23Hughes Yang Chan-Ling T. Vascularization fetal retina: roles vasculogenesis angiogenesis.Invest Ophthalmol Vis Sci. 41: 1217-1228PubMed kidney, peritubular capillaries vasa recta populate medulla cortex similar manner.24Sequeira Lopez M.L. Gomez R.A. Development arterioles.J 2011; 22: 2156-2165Crossref (86) contrast, endothelium develop vasculogenesis, clusters progenitor cells form islands de novo vessels, giving rise corpuscle, respectively24Sequeira Scholar,25Nickla D.L. Wallman multifunctional choroid.Prog 144-168Crossref (683) Scholar; although glomerulus, debated.26Munro D.A.D. Davies J.A. Vascularizing embryo organoid: questioning assumptions vasculogenesis.J 1593-1595Crossref (3) ∼80 nm fenestrations allowing fluid exchange within subretinal space.27Anand-Apte Hollyfield J.G. Developmental anatomy vasculature.in: Dratt Besharse Dana Encyclopedia Eye. Elsevier, Amsterdam2010: 9-15Crossref similarly sized facilitate ultrafiltration Bowman’s capsule.28Haraldsson Nystrom Deen W.M. Properties barrier mechanisms proteinuria.Physiol Rev. 2008; 88: 451-487Crossref (498) medullary circulations each receive <20% total flow, respectively, despite high metabolic activity photoreceptors countercurrent system. regions lower oxygen tension than do cortical counterparts, creating matched corticomedullary gradients receives ∼80% flow passively oxygenates visual apparatus including photoreceptors, particularly avascular fovea.25Nickla role demands 4-fold higher per unit mass 10-fold brain,25Nickla indicating importance global Choroidal change therefore predate onset overt and, if detectable, All components renin-angiotensin-aldosterone widely expressed throughout 2).29Wilkinson-Berka J.L. Agrotis Deliyanti renin-angiotensin system: aldosterone.Peptides. 36: 142-150Crossref (43) via I receptors leads vasoconstriction30Rockwood E.J. Fantes Davis E.B. Anderson D.R. response vasculature angiotensin.Invest 1987; 676-682PubMed but modulate glial-pericyte-vasomotor signaling maintains integrity.31Fletcher E.L. Phipps Ward M.M. health influence neurons, glia vasculature.Prog 284-311Crossref (85) Excessive diabetic nondiabetic CKD.32Mauer Zinman Gardiner al.Renal enalapril losartan 1 diabetes.N 2009; 361: 40-51Crossref (530) inhibition trials prevents nephropathy, probably independently pressure (BP).32Mauer eye, endothelin-1 mediates vasoconstriction endothelin-A receptors, localized smooth muscle cells. endothelin-B confined neuronal glial structures.33MacCumber M.W. D’Anna S.A. Endothelin receptor-binding subtypes choroid.Arch 112: 1231-1235Crossref Similarly glomeruli whereas mainly collecting Selective receptor blockade increases reduces pericyte apoptosis thinning mouse model diabetes.34Chou Rollins S.D. Ye al.Endothelin receptor-A antagonist attenuates neuroretinal mice.Invest 2014; 55: 2516-2525Crossref (22) mirrored selective ameliorates intraglomerular podocytopathy, fibrosis slow progression.35Dhaun Goddard Webb D.J. endothelin disease.J 2006; 17: 943-955Crossref (159) Scholar,36Heerspink H.J.L. Parving H.-H. Andress al.Atrasentan events (SONAR): double-blind, randomised, placebo-controlled trial.Lancet. 2019; 393: 1937-1947Abstract (51) Autonomic innervation limited sympathetic vasoconstriction25Nickla manner intrarenal vessels. microvasculature, rather accurately excessive activation, CKD.1Gansevoort Qualitative grading (e.g., microaneurysms, hemorrhages, focal arteriolar narrowing) computer-assisted quantitative caliber fundus photographs mainstay last 20 years S2). reflects established damage, detecting damage patients.37Wong T.Y. Mitchell hypertension.Lancet. 2007; 369: 425-435Abstract (342) derived venular widths close optic disc (Table 1; Supplementary Novel indices geometry, fractal dimension (Dfs), skeletonized maps 3). suboptimal branching patterns promote disease.38Murray physiological principle minimum work: I. cost volume.Proc Natl Acad Sci U S 1926; 207-214Crossref Scholar,39Patton Aslam T.M. MacGillivray al.Retinal image analysis: concepts, applications potential.Prog 25: 99-127Crossref (438) severity retinopathy, change, deviations well points.Table 1Retinal photographyMetricDerivationInterpretationStrengthsWeaknessesCRAEWidths reflective erythrocyte column lumen 6 largest arterioles located zone 0.5–1 diameters away marginSummarized surrogate measure internal narrowing wideningProvides insight affecting arteriolesRelatively easy obtain automateSummarized absolute valuesPotential magnification positioning errorsValues not true nor cross-sectional area relevant diseaseCRVEWidths venules venulesRelatively diseaseAVRRatio CRAE CRVEChanges usually indicative generalized narrowingAvoids errorsDimensionlessProvides little underlying pathophysiologyIf used alone, it lead incorrect inferences: CRVE narrow increasing pressure, producing normal AVR masking any associationDfImages binarized broken short segments (skeletonization)Entire divided boxes, containing segment counted. process repeated different box sizes. number boxes plotted imageIndex spatial occupancy (complexity)Reduced (sparse) (dense) complexity relative cohort geometryBased robust models optimality branchingMay sensitive calibers reflecting other organ bedsLess studied calibersSimplifies 3-dimensional 2-dimensional mapsAVR, arteriole-to-venule ratio; CRAE; central equivalent; CRVE, Df, dimension. Open table tab AVR, thought tone. Large studies demonstrate strong independent associations BP narrowing.40Cheung C.Y. Ikram M.K. Sabanayagam C. Wong study manifestations hypertension.Hypertension. 60: 1094-1103Crossref (115) Longitudinal shown ∼2-fold age, sex, baseline BP, Table S1), supporting able individuals. paradigm challenged recently data suggesting masked time detected ambulatory monitoring.41Wei F.F. Zhang Z.Y. Thijs L. al.Conventional predictors narrowing.Hypertension. 511-520Crossref Additionally, systolic mean arterial show inverse relationship Df keeping rarefaction.42Liew Wang J.J. Cheung fractal: methodology, reliability, pressure.Ophthalmology. 115: 1951-1956Abstract (122) 43Cheung Tay W.T. al.Quantitative qualitative characteristics pressure.J 1380-1391Crossref (121) 44Cheung Thomas W. factors.Am 154: 663-674.e661Abstract holds young children population should confounding factors) caliber.45Kurniawan E.D. al.Elevated rarefaction children.Invest 53: 470-474Crossref Diabetic complications likely disease.7Stehouwer More so widening prevalent correlates predicts caliber.46Nguyen T.T. Sharrett A.R. al.Relationship retinopathy: Multi-Ethnic Study Atherosclerosis (MESA).Diabetes Care. 31: 544-549Crossref (126) Wider seen hypoxia47Saldívar E. Cabrales Tsai A.G. Intaglietta Microcirculatory during adaptation hypoxia.Am Physiol Heart Circ Physiol. 2003; 285: H2064-H2071Crossref associate dysfunction,48Nguyen Islam F.M. Farouque H.M. brachial flow-mediated dilation: Atherosclerosis.Stroke. 1343-1348Crossref they stress derangement. concept, cholesterol level, body index, worse glycemic control wider venules.49Ikram Jong F.J. Vingerling al.Are disorders? Rotterdam Study.Invest 2129-2134Crossref (360) 50Klein Klein B.E.K. Moss S.E. persons diabetes: Wisconsin Epidemiologic Retinopathy: XVIII.Ophthalmology. 110: 2118-2125Abstract 51Klein Epidemiological XX.Ophthalmology. 113: 1488-1498Abstract 52Owen C.G. Rudnicka Welikala vasculometry cardiometabolic Prospective Investigation Cancer-Norfolk Study.Ophthalmology. 126: 96-106Abstract (4) smaller ratio hyperglycemia over 5 10 years, insulin family history S2).53Sabanayagam Lye W.K. calibre mellitus: systematic review participant-level meta-analysis.Diabetologia. 58: 2476-2485Crossref Finally, neuropathy, strength modest.54Grauslund Green Kawasaki fractals macrovascular diabetes.Ophthalmology. 117: 1400-1405Abstract (72) Scholar,55Cheung Law A.K. geometry year retinopathy.Diabetologia. 1770-1781Crossref Retinopathy (diabetic, hypertensive, otherwise) standard proteinuria.56Grunwald J.E. Alexander Maguire al.Prevalence patie

Language: Английский

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Optical Coherence Tomography Angiography Features in Post-COVID-19 Pneumonia Patients: A Pilot Study

American Journal of Ophthalmology, Journal Year: 2021, Volume and Issue: 227, P. 182 - 190

Published: March 27, 2021

Language: Английский

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Optical coherence tomography angiography changes in cardiovascular systemic diseases and risk factors: A Review

Acta Ophthalmologica, Journal Year: 2021, Volume and Issue: 100(1)

Published: March 29, 2021

Abstract Cardiovascular (CV) disease (CVD) is the main cause of death around world, and assessing a patient’s CV risk factors (CVRF) can play major role in its prevention. Since it has been shown that retinal vascular alterations may reflect several systemic processes such as CVRF, we conducted systematic review order to summarize which ocular microvasculature changes be found using Optical Coherence Tomography Angiography (OCTA) patients without diseases with pathologies/conditions affect system when compared healthy subjects. We searched on online databases, namely PubMed, Scopus, Cochrane Web Science, obtained additional studies through citation tracking. Case reports articles were excluded. A total 47 included our review. describe hypertension, diabetes mellitus, kidney disease, preeclampsia, coronary artery carotid stenosis obstructive sleep apnoea syndrome have, general, lower choroidal Vessel Density (VD) Length (VL), well an increased foveal avascular zone area perimeter. Additionally, characteristics and/or conditions subjects, smoking status, hyper or hypoxia conditions, race, among others, are also related should accounted for. concluded OCTA could useful tool assess profile non‐invasive way, possibly integrating diagnostic prognostic algorithms most prevalent future.

Language: Английский

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Subretinal drusenoid deposits, age-related macular degeneration, and cardiovascular disease

Asia-Pacific Journal of Ophthalmology, Journal Year: 2024, Volume and Issue: 13(1), P. 100036 - 100036

Published: Jan. 1, 2024

Decades of studies on age-related macular degeneration (AMD), cardiovascular disease and stroke have not found consistent associations between AMD systemic vascular disease. This study suggests that there is in fact no general relationship, but instead a strong, specific association only the subretinal drusenoid deposit (SDD) phenotype retinal imaging certain co-existent diseases are high risk for compromised cardiac output or internal carotid artery stenosis. Future screening initiatives these -risk (HRVDs) with fast, inexpensive could make significant contribution to public health save lives. Likewise, patients known HRVDs unrecognized SDD form enable needed treatment vision.

Language: Английский

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Retinal Imaging-Based Oculomics: Artificial Intelligence as a Tool in the Diagnosis of Cardiovascular and Metabolic Diseases

Biomedicines, Journal Year: 2024, Volume and Issue: 12(9), P. 2150 - 2150

Published: Sept. 23, 2024

Cardiovascular diseases (CVDs) are a major cause of mortality globally, emphasizing the need for early detection and effective risk assessment to improve patient outcomes. Advances in oculomics, which utilize relationship between retinal microvascular changes systemic vascular health, offer promising non-invasive approach assessing CVD risk. Retinal fundus imaging optical coherence tomography/angiography (OCT/OCTA) provides critical information diagnosis, with parameters such as vessel caliber, tortuosity, branching patterns identified key biomarkers. Given large volume data generated during routine eye exams, there is growing automated tools aid diagnosis prediction. The study demonstrates that AI-driven analysis images can accurately predict cardiovascular factors, events, metabolic diseases, surpassing traditional diagnostic methods some cases. These models achieved area under curve (AUC) values ranging from 0.71 0.87, sensitivity 71% 89%, specificity 40% 70%, This highlights potential component personalized medicine, enabling more precise earlier intervention. It not only aids detecting abnormalities may precede events but also offers scalable, non-invasive, cost-effective solution widespread screening. However, article emphasizes further research standardize protocols validate clinical utility these biomarkers across different populations. By integrating oculomics into practice, healthcare providers could significantly enhance management ultimately improving Fundus image thus represents valuable tool future precision medicine health management.

Language: Английский

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Oculomics: A Crusade Against the Four Horsemen of Chronic Disease

Ophthalmology and Therapy, Journal Year: 2024, Volume and Issue: 13(6), P. 1427 - 1451

Published: April 17, 2024

Chronic, non-communicable diseases present a major barrier to living long and healthy life. In many cases, early diagnosis can facilitate prevention, monitoring, treatment efforts, improving patient outcomes. There is therefore critical need make screening techniques as accessible, unintimidating, cost-effective possible. The association between ocular biomarkers systemic health disease (oculomics) presents an attractive opportunity for detection of diseases, ophthalmic are often relatively low-cost, fast, non-invasive. this review, we highlight the key associations structural in eye four globally leading causes morbidity mortality: cardiovascular disease, cancer, neurodegenerative metabolic disease. We observe that particularly promising target oculomics, with detected multiple structures. Cardiovascular choroid, retinal vasculature, nerve fiber layer, eyelid, tear fluid, lens, vasculature. contrast, only fluid emerged cancer. retina rich source oculomics data, analysis which has been enhanced by artificial intelligence-based tools. Although not all disease-specific, limiting their current diagnostic utility, future research will likely benefit from combining data various structures improve specificity, well active design, development, optimization instruments specific signatures, thus facilitating differential diagnoses. Long-term stop people lives. help prevent, monitor, treat patients' health. order diagnose tools easy patients access, painless, low-cost. may provide solution. discuss link changes types long-term that, together, kill most population: (1) (affecting heart and/or blood). (2) Cancer (abnormal growth cells). (3) Neurodegenerative brain nervous system). (4) Metabolic (problems storing, accessing, using body's fuel). show leaves tell-tale signs lots different parts eye. Signs mostly found back eye, cancer be fluid. seen them tell us what is. believe understand more about how detect it if combine information within develop new these

Language: Английский

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Optical coherence tomography angiography of the retina and choroid in systemic diseases

Progress in Retinal and Eye Research, Journal Year: 2024, Volume and Issue: 103, P. 101292 - 101292

Published: Aug. 30, 2024

Optical coherence tomography angiography (OCTA) has transformed ocular vascular imaging, revealing microvascular changes linked to various systemic diseases. This review explores its applications in diabetes, hypertension, cardiovascular diseases, and neurodegenerative While OCTA provides a valuable window into the body's microvasculature, interpreting findings can be complex. Additionally, challenges exist due relative non-specificity of where observed might not unique specific disease, variations between machines, lack standardized normative database for comparison, potential image artifacts. Despite these limitations, holds immense future. The highlights promising advancements like quantitative analysis images, integration artificial intelligence faster more accurate interpretation, multi-modal imaging combining with other techniques comprehensive characterization vasculature. Furthermore, OCTA's future role personalized medicine, enabling tailored treatment plans based on individual findings, community screening programs early disease detection, longitudinal studies tracking progression over time is also discussed. In conclusion, presents significant opportunity improve our understanding management Addressing current limitations pursuing exciting directions solidify as an indispensable tool diagnosis, monitoring progression, potentially guiding decisions across health conditions.

Language: Английский

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