Abstract

Retinal blood flow (RBF) information has the potential to offer insight into ophthalmic health and disease that is complementary to traditional anatomical biomarkers as well as to retinal perfusion information provided by fluorescence or optical coherence tomography angiography (OCT-A). The present study was performed to test the functional attributes and performance of the XyCAM RI, a non-invasive imager that obtains and assesses RBF information. The XyCAM RI was installed and used in two different settings to obtain video recordings of the blood flow in the optic nerve head region in eyes of healthy subjects. The mean blood flow velocity index (BFVi) in the optic disc and in each of multiple arterial and venous segments was obtained and shown to reveal a temporal waveform with a peak and trough that correlates with a cardiac cycle as revealed by a reference pulse oximeter (correlation between respective peak-to-peak distances was 0.977). The intra-session repeatability of the XyCAM RI was high with a coefficient of variation (CV) of 1.84 ± 1.13% across both sites. Artery-vein comparisons were made by estimating, in a pair of adjacent arterial and venous segments, various temporal waveform metrics such as pulsatility index, percent time in systole and diastole, and change in vascular blood volume over a cardiac cycle. All arterial metrics were shown to have significant differences with venous metrics (p < 0.001). The XyCAM RI, therefore, by obtaining repeatable blood flow measurements with high temporal resolution, permits the differential assessment of arterial and venous blood flow patterns in the retina that may facilitate research into disease pathophysiology and biomarker development for diagnostics.

Highlights

  • Retinal blood flow (RBF) information has the potential to offer insight into ophthalmic health and disease that is complementary to traditional anatomical biomarkers as well as to retinal perfusion information provided by fluorescence or optical coherence tomography angiography (OCT-A)

  • This resulted in a total of eight subjects with complete imaging at Site 2. Both eyes were imaged for all subjects, resulting in retinal blood flow data collected from a total of 36 eyes across both sites

  • Retinal image data was captured at 82 frames per second, and post-processed to reveal maps of blood flow velocity indices (BFVi), available at a temporal resolution of 82 Hz

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Summary

Introduction

Retinal blood flow (RBF) information has the potential to offer insight into ophthalmic health and disease that is complementary to traditional anatomical biomarkers as well as to retinal perfusion information provided by fluorescence or optical coherence tomography angiography (OCT-A). The XyCAM RI, by obtaining repeatable blood flow measurements with high temporal resolution, permits the differential assessment of arterial and venous blood flow patterns in the retina that may facilitate research into disease pathophysiology and biomarker development for diagnostics. Reliable imaging of retinal blood flow has the potential to complement traditional biomarkers with important clues that may enable disease diagnostics in the early stage prior to the development of vivid anatomical symptoms. A commercially available retinal imager that uses laser speckle flowgraphy, the LSFG-NAVI (Softcare Co. Ltd., Japan)[51], has displayed reduced blood flow in g­ laucoma[52] and diabetic r­ etinopathy[53]. Since retinal blood flow fluctuates over the duration of a heart beat, monitoring the temporal dynamics of retinal vessels may reveal additional changes in ocular pathologies

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