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Joel S Schuman - One of the best experts on this subject based on the ideXlab platform.
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development validation and innovation in ophthalmic laser based Imaging report from a us food and drug administration cosponsored forum
JAMA Ophthalmology, 2020Co-Authors: Frank L Brodie, Michael X Repka, Stephen A Burns, Grace S Prakalapakorn, Christie L Morse, Joel S Schuman, Michael R Duenas, Natalie A Afshari, John S PollackAbstract:In April 2019, the US Food and Drug Administration, in conjunction with 11 professional ophthalmic, vision science, and optometric societies, convened a forum on laser-based Imaging. The forum brought together the Food and Drug Administration, clinicians, researchers, industry members, and other stakeholders to stimulate innovation and ensure that patients in the US are the first in the world to have access to high-quality, safe, and effective medical devices. This conference focused on the technology, clinical applications, regulatory issues, and reimbursement issues surrounding innovative Ocular Imaging modalities. Furthermore, the emerging role of artificial intelligence in ophthalmic Imaging was reviewed. This article summarizes the presentations, discussion, and future directions.
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Imaging of the optic nerve and retinal nerve fiber layer an essential part of glaucoma diagnosis and monitoring
Survey of Ophthalmology, 2014Co-Authors: Jacek Kotowski, Gadi Wollstein, Hiroshi Ishikawa, Joel S SchumanAbstract:Because glaucomatous damage is irreversible early detection of structural changes in the optic nerve head and retinal nerve fiber layer is imperative for timely diagnosis of glaucoma and monitoring of its progression. Significant improvements in Ocular Imaging have been made in recent years. Imaging techniques such as optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy rely on different properties of light to provide objective structural assessment of the optic nerve head, retinal nerve fiber layer and macula. In this review, we discuss the capabilities of these Imaging modalities pertinent for diagnosis of glaucoma and detection of progressive glaucomatous damage and provide a review of the current knowledge on the clinical performance of these technologies.
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automated assessment of the optic nerve head on stereo disc photographs
Investigative Ophthalmology & Visual Science, 2008Co-Authors: Juan Xu, Gadi Wollstein, Hiroshi Ishikawa, Richard A Bilonick, Kyung Rim Sung, Larry Kagemann, K A Townsend, Joel S SchumanAbstract:Glaucoma is the second most common cause of blindness worldwide, characterized by progressive damage of the optic nerve that may result in increasing visual field (VF) loss and eventual irreversible blindness.1,2 Although Ocular Imaging instruments provide clinically useful quantitative assessment for glaucoma diagnosis and management, it is still the clinical standard to perform subjective optic disc assessment using ophthalmoscopy and disc photographs. Stereo disc photography has been used to document structural abnormalities and longitudinal changes in glaucomatous eyes for decades. It is the most common widely used method for optic nerve head (ONH) Imaging for analysis and diagnosis. Disc photographs are highly reproducible and record a natural color image of the retina.2 One of the limitations of stereo disc photography, however, is that there is no fully automated ONH quantification method available. Conventional ONH evaluation includes estimation of the ONH dimensions by observing the image pair with a stereo viewer. Alternatively, computerized planimetry lets clinicians manually label the disc and cup margins and consequently generate several disc parameters.3,4 This procedure is time consuming, labor intensive, and prone to high intra- and interobserver variability.4,5 In several studies, investigators used computerized methods for analyzing ONH structures, but these methods were all based on a single automated analysis technique, such as three-dimensional (3-D) ONH modeling6–8 or disc margin detection,9–16 and none of the studies integrated multiple techniques. Meanwhile, numerous techniques to identify the cup within 3-D topographic data have been proposed.17–21 Previous studies have defined the top of the cup as 150 μm, 120 μm, one half, and one third of the distance posterior to the disc margin; all defined the bottom of the cup as the deepest point.17–21 No gold standard criterion for the location of the anterior surface of the cup exists. We developed a fully automated system to perform ONH analysis from stereoscopic photographs using multiple-analysis methods that enabled the segmentation of all pixels in the image into disc, cup, and background regions based on the 3-D reconstructed model. The purpose of this study was to evaluate the glaucoma discriminating ability of the automated segmentation software of stereoscopic ONH photographs in comparison with human expert assessment.
Chianshiu Chien - One of the best experts on this subject based on the ideXlab platform.
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dual supramolecular nanoparticle vectors enable crispr cas9 mediated knockin of retinoschisin 1 gene a potential nonviral therapeutic solution for x linked juvenile retinoschisis
Advanced Science, 2020Co-Authors: Shihjie Chou, Peng Yang, Qian Ban, Yiping Yang, Monglien Wang, Chianshiu ChienAbstract:The homology-independent targeted integration (HITI) strategy enables effective CRISPR/Cas9-mediated knockin of therapeutic genes in nondividing cells in vivo, promising general therapeutic solutions for treating genetic diseases like X-linked juvenile retinoschisis. Herein, supramolecular nanoparticle (SMNP) vectors are used for codelivery of two DNA plasmids-CRISPR-Cas9 genome-editing system and a therapeutic gene, Retinoschisin 1 (RS1)-enabling clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein 9 (CRISPR/Cas9) knockin of the RS1 gene with HITI. Through small-scale combinatorial screenings, two SMNP vectors, with Cas9 and single guide RNA (sgRNA)-plasmid in one and Donor-RS1 and green fluorescent protein (GFP)-plasmid in the other, with optimal delivery performances are identified. These SMNP vectors are then employed for CRISPR/Cas9 knockin of RS1/GFP genes into the mouse Rosa26 safe-harbor site in vitro and in vivo. The in vivo study involves intravitreally injecting the two SMNP vectors into the mouse eyes, followed by repeated Ocular Imaging by fundus camera and optical coherence tomography, and pathological and molecular analyses of the harvested retina tissues. Mice Ocular organs retain their anatomical integrity, a single-copy 3.0-kb RS1/GFP gene is precisely integrated into the Rosa26 site in the retinas, and the integrated RS1/GFP gene is expressed in the retinas, demonstrating CRISPR/Cas9 knockin of RS1/GFP gene.
Yannis M Paulus - One of the best experts on this subject based on the ideXlab platform.
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high resolution multimodal photoacoustic microscopy and optical coherence tomography image guided laser induced branch retinal vein occlusion in living rabbits
Scientific Reports, 2019Co-Authors: Van Phuc Nguyen, Wei Zhang, Xueding Wang, Yannis M PaulusAbstract:Joint high-resolution multimodal photoacoustic microscopy (PAM) and optical coherence tomography (OCT) was developed to improve the efficiency for visualizing newly developed retinal neovascularization (RNV) and to monitor the dynamic changes of retinal vein occlusion (RVO) in living rabbits. The RNV and RVO models were created in New Zealand rabbits by Rose Bengal laser-induced RVO. Dual modalities Imaging equipment, including color fundus photography, fluorescein angiography (FA), OCT, and PAM, was used to image and assess the changes of retinal vasculature. In vivo experimental results exhibited that not only the treatment boundaries and the position of the occluded vasculature but also the structure of individual RNV were markedly observed using PAM platform with great resolution and high image contrast. The laser light energy of 80 nJ was used to induce photoacoustic signal, which is approximately half the energy of the American National Standards Institute safety limit. A cross-sectional structure of RNV was identified with the OCT modality. Furthermore, vibrant transformations in the RNV and the retinal morphology were examined at different times after laser occlusion: days 4, 28, 35, 49, and 90. PAM revealed high contrast and high resolution vascular Imaging of the retina and choroid with amplified penetration depth. Through the present custom-built Imaging system, both RNV and RVO can be reconstructed and observed in two and three dimensions. A unique dual modality A unique dual modality PAM and OCT can help precisely visualize and distinguish individual microvessels, microvessel depth, and the surrounding anatomy. Thus, the proposed multimodal Ocular Imaging platform may offer a potential equipment to enhance classification of microvasculature in a reliable and proficient manner in larger rabbit eyes.
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photoacoustic ophthalmoscopy principle application and future directions
Journal of Imaging, 2018Co-Authors: Van Phuc Nguyen, Yannis M PaulusAbstract:Photoacoustic ophthalmoscopy (PAOM) is a novel, hybrid, non-ionizing, and non-invasive Imaging technology that has been used to assess the retina. PAOM can provide both anatomic and functional retinal characterizations with high resolution, high sensitivity, high contrast, and a high depth of penetration. Thus, Ocular diseases can be precisely detected and visualized at earlier stages, resulting in an improved understanding of pathophysiology, improved management, and the improved monitoring of retinal treatment to prevent vision loss. To better visualize Ocular components such as retinal vessels, choroidal vessels, choroidal neovascularization, retinal neovascularization, and the retinal pigment epithelium, an advanced multimodal Ocular Imaging platform has been developed by a combination of PAOM with other optical Imaging techniques such as optical coherence tomography (OCT), scanning laser ophthalmoscopy (SLO), and fluorescence microscopy. The multimodal images can be acquired from a single Imaging system and co-registered on the same image plane, enabling an improved evaluation of disease. In this review, the potential application of photoacoustic ophthalmoscopy in both research and clinical diagnosis are discussed as a medical screening technique for the visualization of various Ocular diseases. The basic principle and requirements of photoacoustic Ocular Imaging are introduced. Then, various photoacoustic microscopy Imaging systems of the retina in animals are presented. Finally, the future development of PAOM and multimodal Imaging is discussed.
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novel photoacoustic microscopy and optical coherence tomography dual modality chorioretinal Imaging in living rabbit eyes
Journal of Visualized Experiments, 2018Co-Authors: Chao Tian, Wei Zhang, Van Phuc Nguyen, Xueding Wang, Yannis M PaulusAbstract:Photoacoustic Ocular Imaging is an emerging ophthalmic Imaging technology that can noninvasively visualize Ocular tissue by converting light energy into sound waves and is currently under intensive investigation. However, most reported work to date is focused on the Imaging of the posterior segment of the eyes of small animals, such as rats and mice, which poses challenges for clinical human translation due to small eyeball sizes. This manuscript describes a novel photoacoustic microscopy (PAM) and optical coherence tomography (OCT) dual-modality system for posterior segment Imaging of the eyes of larger animals, such as rabbits. The system configuration, system alignment, animal preparation, and dual-modality experimental protocols for in vivo, noninvasive, label-free chorioretinal Imaging in rabbits are detailed. The effectiveness of the method is demonstrated through representative experimental results, including retinal and choroidal vasculature obtained by the PAM and OCT. This manuscript provides a practical guide to reproducing the Imaging results in rabbits and advancing photoacoustic Ocular Imaging in larger animals.
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In Vivo 3D Imaging of Retinal Neovascularization Using Multimodal Photoacoustic Microscopy and Optical Coherence Tomography Imaging
MDPI AG, 2018Co-Authors: Van Phuc Nguyen, Wei Zhang, Xueding Wang, Michael Aaberg, Yannis M PaulusAbstract:The pathological process of neovascularization of the retina plays a critical role in causing vision loss in several diseases, including diabetes, retinal vein occlusion, and sickle cell disease. Retinal neovascularization can lead to vitreous hemorrhage and retinal detachment, yet the pathological process of neovascularization is a complex phenomenon under active investigation. Understanding and monitoring retinal neovascularization is critically important in clinical ophthalmology. This study describes a novel multimodal Ocular Imaging system which combines photoacoustic microscopy (PAM) and a spectral domain optical coherence tomography (SD-OCT) to improve the visualization of retinal neovascularization (RNV), their depth, and the surrounding anatomy in living rabbits. RNV was induced in New Zealand rabbits by intravitreal injection of vascular endothelial growth factor (VEGF). The retinal vasculature before and after injection at various times was monitored and evaluated using multimodal Imaging including color fundus photography, fluorescein angiography (FA), OCT, and PAM. In vivo experiments demonstrate that PAM Imaging distinctly characterized the location as well as the morphology of individual RNV with high contrast at a safe laser energy of 80 nJ. SD-OCT was used to identify a cross-sectional structure of RNV. In addition, dynamic changes in the retinal morphology and retinal neovascularization were observed at day 4, 5, 6, 7, 9, 11, 14, 28, and day 35 after VEGF injection. PAM demonstrated high-resolution optical absorption of hemoglobin and vascular Imaging of the retina and choroid with increased depth of penetration. With the current multimodal Imaging system, RNV can be easily visualized in both 2D and 3D angiography. This multimodal Ocular Imaging system provides improved characterization of the microvasculature in a safe manner in larger rabbit eyes
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noninvasive chorioretinal Imaging in living rabbits using integrated photoacoustic microscopy and optical coherence tomography
Optics Express, 2017Co-Authors: Chao Tian, Wei Zhang, Xueding Wang, Aghapi Mordovanakis, Yannis M PaulusAbstract:Most reported photoacoustic Ocular Imaging work to date uses small animals, such as mice and rats, the eyeball sizes of which are less than one-third of those of humans, posing challenges for clinical translation. Here we developed a novel integrated photoacoustic microscopy (PAM) and optical coherence tomography (OCT) system for dual-modality chorioretinal Imaging of larger animals, such as rabbits. The system has quantified lateral resolutions of 4.1 µm (PAM) and 3.8 µm (OCT), and axial resolutions of 37.0 µm (PAM) and 4.0 µm (OCT) at the focal plane of the objective. Experimental results in living rabbits demonstrate that the PAM can noninvasively visualize individual depth-resolved retinal and choroidal vessels using a laser exposure dose of ~80 nJ below the American National Standards Institute (ANSI) safety limit 160 nJ at 570 nm; and the OCT can finely distinguish different retinal layers, the choroid, and the sclera. This reported work may be a major step forward in clinical translation of the technology.
Franziska G Rauscher - One of the best experts on this subject based on the ideXlab platform.
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renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness the life adult study
BMC Medicine, 2021Co-Authors: Franziska G Rauscher, Mengyu Wang, Kerstin Wirkner, Joachim Thiery, Christoph Engel, Mike Francke, Anke Tonjes, Peter Stenvinkel, Michael StumvollAbstract:BACKGROUND Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. METHODS The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and Ocular Imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. RESULTS In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. CONCLUSIONS Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT.
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Renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness—the LIFE-Adult Study
'Springer Science and Business Media LLC', 2021Co-Authors: Franziska G Rauscher, Mengyu Wang, Kerstin Wirkner, Joachim Thiery, Christoph Engel, Mike Francke, Anke Tonjes, Peter Stenvinkel, Michael Stumvoll, Markus LoefflerAbstract:Abstract Background Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. Methods The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and Ocular Imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. Results In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. Conclusions Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT
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sex specific differences in circumpapillary retinal nerve fiber layer thickness
Ophthalmology, 2020Co-Authors: Franziska G Rauscher, Eun Young Choi, Mengyu Wang, Neda Baniasadi, Kerstin Wirkner, Toralf Kirsten, Joachim Thiery, Christoph Engel, Markus Loeffler, Tobias ElzeAbstract:Purpose To investigate the role of sex on retinal nerve fiber layer (RNFL) thickness at 768 circumpapillary locations based on OCT findings. Design Population-based cross-sectional study. Participants We investigated 5646 eyes of 5646 healthy participants from the Leipzig Research Centre for Civilization Diseases (LIFE)-Adult Study of a predominantly white population. Methods All participants underwent standardized systemic assessments and Ocular Imaging. Circumpapillary RNFL (cRNFL) thickness was measured at 768 points equidistant from the optic nerve head using spectral-domain OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany). To control Ocular magnification effects, the true scanning radius was estimated by scanning focus. Student t test was used to evaluate sex differences in cRNFL thickness globally and at each of the 768 locations. Multivariable linear regression and analysis of variance were used to evaluate individual contributions of various factors to cRNFL thickness variance. Main Outcome Measures Difference in cRNFL thickness between males and females. Results Our population consisted of 54.8% females. The global cRNFL thickness was 1 μm thicker in females (P Conclusions Substantial sex effects on cRNFL thickness were found at 56.8% of all 768 circumpapillary locations, with specific patterns for different sectors. Over large regions, sex was at least as important in explaining the cRNFL thickness variance as was age, which is well established to have a substantial impact on cRNFL thickness. Including sex in the cRNFL thickness norm could therefore improve glaucoma diagnosis and monitoring.
Mengyu Wang - One of the best experts on this subject based on the ideXlab platform.
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renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness the life adult study
BMC Medicine, 2021Co-Authors: Franziska G Rauscher, Mengyu Wang, Kerstin Wirkner, Joachim Thiery, Christoph Engel, Mike Francke, Anke Tonjes, Peter Stenvinkel, Michael StumvollAbstract:BACKGROUND Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. METHODS The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and Ocular Imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. RESULTS In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. CONCLUSIONS Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT.
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Renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness—the LIFE-Adult Study
'Springer Science and Business Media LLC', 2021Co-Authors: Franziska G Rauscher, Mengyu Wang, Kerstin Wirkner, Joachim Thiery, Christoph Engel, Mike Francke, Anke Tonjes, Peter Stenvinkel, Michael Stumvoll, Markus LoefflerAbstract:Abstract Background Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. Methods The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and Ocular Imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. Results In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. Conclusions Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT
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sex specific differences in circumpapillary retinal nerve fiber layer thickness
Ophthalmology, 2020Co-Authors: Franziska G Rauscher, Eun Young Choi, Mengyu Wang, Neda Baniasadi, Kerstin Wirkner, Toralf Kirsten, Joachim Thiery, Christoph Engel, Markus Loeffler, Tobias ElzeAbstract:Purpose To investigate the role of sex on retinal nerve fiber layer (RNFL) thickness at 768 circumpapillary locations based on OCT findings. Design Population-based cross-sectional study. Participants We investigated 5646 eyes of 5646 healthy participants from the Leipzig Research Centre for Civilization Diseases (LIFE)-Adult Study of a predominantly white population. Methods All participants underwent standardized systemic assessments and Ocular Imaging. Circumpapillary RNFL (cRNFL) thickness was measured at 768 points equidistant from the optic nerve head using spectral-domain OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany). To control Ocular magnification effects, the true scanning radius was estimated by scanning focus. Student t test was used to evaluate sex differences in cRNFL thickness globally and at each of the 768 locations. Multivariable linear regression and analysis of variance were used to evaluate individual contributions of various factors to cRNFL thickness variance. Main Outcome Measures Difference in cRNFL thickness between males and females. Results Our population consisted of 54.8% females. The global cRNFL thickness was 1 μm thicker in females (P Conclusions Substantial sex effects on cRNFL thickness were found at 56.8% of all 768 circumpapillary locations, with specific patterns for different sectors. Over large regions, sex was at least as important in explaining the cRNFL thickness variance as was age, which is well established to have a substantial impact on cRNFL thickness. Including sex in the cRNFL thickness norm could therefore improve glaucoma diagnosis and monitoring.
