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Visualization of three-dimensional microcirculation of rodents' retina and choroid for studies of critical illness using optical coherence tomography angiography.

ABSTRACT: We developed a method to measure the relative blood flow speed using optical coherence tomography angiography (OCTA) in retina and choroid, and investigated the feasibility of this method for assessing microcirculatory function in rat models of sepsis and hemorrhagic shock. Two sepsis models, 6-h severe sepsis without treatment and 30-h moderate sepsis maintaining mean arterial pressure, and volume controlled hemorrhagic shock and fluid resuscitation model were used to see the change of microcirculation. The blood flow index (BFI), which was calculated from the OCTA images to represent the average relative blood flow, was decreasing during the 6-h severe sepsis model. Its change is in parallel with the mean arterial blood pressure (MAP) and blood lactate levels. In the 30-h moderate sepsis model, the BFI was decreased while maintaining MAP, and lactate was increased. In the hemorrhagic shock model, the change of BFI is in line with MAP and lactate levels. In all models, BFI change is more sensitive in choroid than in retina. This study presents the OCTA-based retinal and choroidal microcirculatory blood flow monitoring method and shows its utility for assessment of critical illness.

SUBMITTER: Park JR

PROVIDER: S-EPMC8275781 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Visualization of three-dimensional microcirculation of rodents' retina and choroid for studies of critical illness using optical coherence tomography angiography.

Park Jang Ryul JR Lee ByungKun B Lee Min Ji MJ Kim Kyuseok K Oh Wang-Yuhl WY

Scientific reports 20210712 1

We developed a method to measure the relative blood flow speed using optical coherence tomography angiography (OCTA) in retina and choroid, and investigated the feasibility of this method for assessing microcirculatory function in rat models of sepsis and hemorrhagic shock. Two sepsis models, 6-h severe sepsis without treatment and 30-h moderate sepsis maintaining mean arterial pressure, and volume controlled hemorrhagic shock and fluid resuscitation model were used to see the change of microcir ...[more]

PMID: 34253747

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Project description:PurposeWe evaluated the repeatability of wide-field en face swept-source optical coherence tomography angiography (SS-OCTA) in healthy subjects.MethodsHealthy subjects underwent two imaging sessions, on average 8 days apart, with a 100 kHz SS-OCTA instrument. The imaging protocol included a central 3 × 3 and 12 × 12 mm scans of the four quadrants resulting in more than a 70° wide-field OCTA of the posterior pole. Quantitative analysis was performed using the inbuilt Macular Density Algorithm Version v0.6.1 and AngioTool software. Consistency for the foveal avascular zone (FAZ), vessel density, and perfusion density of the superficial and deep capillary plexus slabs and the wide-field OCTA superficial slab, and the number of artefacts on the wide-field images were assessed.ResultsA total of 21 healthy volunteers (seven men and 14 women; mean age 32 years; range, 18-61; standard deviation, 10.28 years) were included in this analysis. Internal consistency was highest for FAZ area with an intraclass correlation (ICC) = 0.998 (95% confidence interval [CI], 0.997-0.999), a FAZ perimeter with an ICC = 0.995 (95% CI, 0.990-0.997), a FAZ circularity with an ICC= 0.976 (95% CI, 0.956-0.987), followed by the vessel density of the inner ring in the superficial slab with an ICC = 0.834 (95% CI, 0.691-0.911), and a vessel density of the inner ring in the deep slab with an ICC = 0.523 (95% CI, 0.113-0.744).The reproducibility of the average vessels length of the wide-field OCTA cropped images was strong (ICC = 0.801; 95% CI, 0.624-0.895), followed by the reproducibility of total number of junctions (ICC = 0.795; 95% CI, 0.613-0.892) and the vessels percentage area (ICC = 0.662; 95% CI, 0.361-0.821).ConclusionsThe level of reproducibility for assessing the microvascular anatomy in wide-field OCTA is strong and can be used to quantify microvascular changes over time. Refinements in analysis strategies and a consensus of which parameters are most useful for quantitative assessment of wide-field OCTA images would be useful in the future.Translational relevanceThese findings bridge the gap between basic imaging research and clinical use for quantitative wide-field OCTA.

Project description:BackgroundThis study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock.MethodsHaemorrhagic shock was induced in five healthy, anaesthetized sheep by stepwise blood withdrawal of 3 × 10 ml∙kg- 1 body weight. OCT-A imaging of retinal perfusion was performed using an OCT device. Incident dark-field illumination microscopy videos were obtained for the evaluation of conjunctival microcirculation. Haemodynamic variables and flow density data in the OCT angiogram were analysed before and during progressive haemorrhage resulting in haemorrhagic shock as well as after fluid resuscitation with 10 ml∙kg- 1 body weight of balanced hydroxyethyl starch solution (6% HES 130/0.4). Videos of the conjunctival microcirculation were recorded at baseline, in haemorrhagic shock, and after resuscitation. Data are presented as median with interquartile range. Comparisons between time points were made using Friedman's test and the degree of correlation between two variables was expressed as Spearman's rank correlation coefficient.ResultsMean arterial pressure and cardiac index (CI) decreased and lactate concentration increased after induction of shock, and haemodynamics recovered after resuscitation. The flow density in the superficial retinal OCT angiogram decreased significantly after shock induction (baseline 44.7% (40.3; 50.5) vs haemorrhagic shock 34.5% (32.8; 40.4); P = 0.027) and recovered after fluid resuscitation (46.9% (41.7; 50.7) vs haemorrhagic shock; P = 0.027). The proportion of perfused vessels of the conjunctival microcirculation showed similar changes. The flow density measured using OCT-A correlated with the conjunctival microcirculation (perfused vessel density: Spearman's rank correlation coefficient ρ = 0.750, P = 0.001) and haemodynamic parameters (CI: ρ = 0.693, P < 0.001).ConclusionsRetinal flow density, measured using OCT-A, significantly decreased in shock and recovered after fluid therapy in an experimental model of haemorrhagic shock. OCT-A is feasible to assess changes in retinal perfusion in haemorrhagic shock and fluid resuscitation.

Dataset Information

Visualization of three-dimensional microcirculation of rodents' retina and choroid for studies of critical illness using optical coherence tomography angiography.

Publications

Visualization of three-dimensional microcirculation of rodents' retina and choroid for studies of critical illness using optical coherence tomography angiography.

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