Doppler Optical Coherence Tomography Research Articles

Imaging of human corneoscleral junction (Limbus) vasculature with 100 KHz A-scan rate swept-source optical coherence tomography/angiography (OCT/A) system

The study demonstrates in-vivo three-dimensional depth-resolved Optical Coherence Tomography Angiography (OCTA) and Doppler OCT imaging performed on the anterior segment of the human eye. A high-speed swept-source OCT system was developed utilizing a swept-source laser having a 100 kHz A-scan sweep rate and centre wavelength at 1060 nm. The proposed system has an axial resolution of 4.5 µm and a transverse imaging resolution of 14 µm. The Doppler OCT provides information regarding the direction of blood flow in corneoscleral junction vessels, which employs the Joint Spectral and Time domain OCT (STdOCT) method. Parameters influencing the imaging of various vessels, like scanning density, A-scan rate, B-scan averaging, and number of BM scanning repeats, were also studied. Slit lamp images and OCT angiography en-face projections produced from PVOCTA (Phase-variance OCTA) and STdOCTA from the same regular patients were compared in order to demonstrate the additional potential of the system. The vascular systems at the Limbus consisting of circulatory, lymphatic, and aqueous outflow systems were imaged and presented. The output clinical parameters of the system will contribute to understanding the blood circulation with directionality at the limbus location, which can be further utilized to identify glaucoma. In the author's opinion, this article represents the first attempt to provide Doppler OCTA data for the anterior chamber of the human eye.

Scaling laws for near-wall flows of thixo-elasto-viscoplastic fluids in a millifluidic channel

Thixo-elasto-viscoplastic (TEVP) fluids are very complex fluids. In addition to elasticity and viscoplasticity, they exhibit thixotropy, i.e., time-dependent rheology due to breakdown and recovery of internal structures at different length- and timescales. General and consistent methods for a priori flow prediction of TEVP fluids based on rheological characteristics are yet to be developed. We report a combined study of the rheology and flow of 18 samples of different TEVP fluids (three yogurts and three concentrations of Laponite and Carbopol, respectively, in water in both the unstirred and a stirred state). The rheology is determined both with standard protocols and with an ex situ protocol aiming at reproducing the shear history of the fluid in the flow. Micrometer resolution flow measurements in a millimeter scale rectangular duct are performed with Doppler Optical Coherence Tomography (D-OCT). As expected, the results show the existence of a plug flow region for samples with sufficiently high yield stress. At low flow rates, the plug extends almost all the way to the wall and the extent of the plug decreases not only with increased flow rate but also with increased thixotropy. The ex situ rheology protocol enables estimation of the shear rate and shear stress close to the wall, making it possible to identify two scaling laws that relates four different non-dimensional groups quantifying the key properties wall-shear stress and slip velocity. The scaling laws are suggested as an ansatz for a priori prediction of the near-wall flow of TEVP fluids based on shear flow-curves obtained with a rheometer.

A dual-channel visible light optical coherence tomography system enables wide-field, full-range, and shot-noise limited human retinal imaging

Visible light optical coherence tomography (VIS-OCT) is an emerging ophthalmic imaging method featuring ultrahigh depth resolution, retinal microvascular oximetry, and distinct scattering contrast in the visible spectral range. The clinical utility of VIS-OCT is hampered by the fundamental trade-off between the imaging depth range and axial resolution, which are determined by the spectral resolution and bandwidth, respectively. To address this trade-off, here we developed a dual-channel VIS-OCT system with three major advancements including the first linear-in-K VIS-OCT spectrometer to decrease the roll-off, reference pathlength modulation to expand the imaging depth range, and per-A-line noise cancellation to remove excess noise, Due to these unique designs, this system achieves 7.2 dB roll-off over the full 1.74 mm depth range (water) with shot-noise limited performance. The system uniquely enables >60° wide-field imaging which would allow simultaneous imaging of the peripheral retina and optic nerve head, as well as ultrahigh 1.3 µm depth resolution (water). Benefiting from the additional near-infrared (NIR) channel of the dual-channel design, this system is compatible with Doppler OCT and OCT angiography (OCTA). The comprehensive structure-function measurement enabled by this dual-channel VIS-OCT system is an advance towards adoption of VIS-OCT in clinical applications.

Retinal oxygen extraction and hyperemic response in patients with Type II diabetes at different stages of non‐proliferative diabetic retinopathy

Purpose: Diabetic retinopathy (DR) is a worldwide cause of irreversible vision loss. Vascular factors such as reduced oxygen supply and impaired neurovascular coupling play a major role in the development of DR. We therefore investigated retinal oxygen metabolism and functional hyperemia in patients with Type II diabetes at different stages of non‐proliferative DR and healthy controls.Methods: To study retinal oxygen metabolism, a total of 67 patients with Type II diabetes (34 patients with no, 15 with mild and 18 with moderate‐to‐severe DR) and 20 healthy controls were recruited. We used the oxygen module of a Retinal Vessel Analyzer to measure retinal oxygen saturation in arteries and veins, and a custom‐built Doppler optical coherence tomography (DOCT) system to assess total retinal blood flow (TRBF). Values of retinal oxygen saturation and TRBF were then used to calculate retinal oxygen extraction. To measure the hyperaemic response, 29 patients with no, 12 with mild, 15 with moderate‐to‐severe DR and 20 healthy controls were included. Retinal blood flow was assessed before and during visual stimulation by combined measurement of retinal vessel calibres and blood velocity using the Dynamic Vessel Analyzer (Imedos, Germany) and DOCT.Results: Retinal oxygen extraction was lowest in patients with moderate‐to‐severe DR (1.78 ± 0.57 μL O2/min, p = 0.040 vs. healthy controls), followed by mild DR (1.90 ± 0.77 μL O2/min), no DR (2.14 ± 0.6 μL O2/min) and healthy controls (2.24 ± 0.57 μL O2/min). Compared to healthy controls (40.4 ± 27.2%), flicker responses were significantly decreased in patients with DR depending on the stage of DR (no DR 37.7 ± 26.0%, mild DR 26.2 ± 28.2%, moderate‐to‐severe DR 22.3 ± 13.9%; p = 0.035, ANOVA).Conclusions: Our results indicate that retinal oxygen extraction as well as hyperaemic response decreases with increasing severity of DR. Further studies are needed to assess whether these retinal functional changes can be used to identify high‐risk patients.

In vivo burn scar assessment with speckle decorrelation and joint spectral and time domain optical coherence tomography.

Post-burn scars and scar contractures present significant challenges in burn injury management, necessitating accurate evaluation of the wound healing process to prevent or minimize complications. Non-invasive and accurate assessment of burn scar vascularity can offer valuable insights for evaluations of wound healing. Optical coherence tomography (OCT) and OCT angiography (OCTA) are promising imaging techniques that may enhance patient-centered care and satisfaction by providing detailed analyses of the healing process. Our study investigates the capabilities of OCT and OCTA for acquiring information on blood vessels in burn scars and evaluates the feasibility of utilizing this information to assess burn scars. Healthy skin and neighboring scar data from nine burn patients were obtained using OCT and processed with speckle decorrelation, Doppler OCT, and an enhanced technique based on joint spectral and time domain OCT. These methods facilitated the assessment of vascular structure and blood flow velocity in both healthy skin and scar tissues. Analyzing these parameters allowed for objective comparisons between normal skin and burn scars. Our study found that blood vessel distribution in burn scars significantly differs from that in healthy skin. Burn scars exhibit increased vascularization, featuring less uniformity and lacking the intricate branching network found in healthy tissue. Specifically, the density of the vessels in burn scars is 67% higher than in healthy tissue, while axial flow velocity in burn scar vessels is 25% faster than in healthy tissue. Our research demonstrates the feasibility of OCT and OCTA as burn scar assessment tools. By implementing these technologies, we can distinguish between scar and healthy tissue based on its vascular structure, providing evidence of their practicality in evaluating burn scar severity and progression.

Advances in Dynamic Light Scattering Imaging of Blood Flow

AbstractDynamic light scattering (DLS) is a well known experimental approach uniquely suited for the characterization of small particles undergoing Brownian motion in randomly inhomogeneous turbid scattering medium, including water suspension, polymers in solutions, cells cultures, and so on. DLS is based on the illuminating of turbid medium with a coherent laser light and further analyzes the intensity fluctuations caused by the motion of the scattering particles. The DLS‐based spin‐off derivative techniques, such laser Doppler flowmetry (LDF), diffusing wave spectroscopy (DWS), laser speckle contrast imaging (LSCI), and Doppler optical coherence tomography (DOCT), are exploited widely for non‐invasive imaging of blood flow in brain, skin, muscles, and other biological tissues. The recent advancements in the DLS‐based imaging technologies in frame of their application for brain blood flow monitoring, skin perfusion measurements, and non‐invasive blood micro‐circulation characterization are overviewed. The fundamentals, breakthrough potential, and practical findings revealed by DLS‐based blood flow imaging studies, including the limitations and challenges of the approach such as movement artifacts, non‐ergodicity, and overcoming high scattering properties of studied medium, are also discussed. It is concluded that continued research and further technological advancements in DLS‐based imaging will pave the way for new exciting developments and insights into blood flow diagnostic imaging.

Multi-window approach enables two-fold improvement in OCT axial resolution with strong side-lobe suppression and improved phase sensitivity.

A common processing approach for optical coherence tomography (OCT) uses a window function (e.g., Hann or rectangular window) for spectral shaping prior to calculating the Fourier transform. Here we build on a multi-window approach [Opt. Express8, 5267 (2017)10.1364/BOE.8.005267] that enables improved resolution while still suppressing side-lobe intensity. The shape of the window function defines the trade-off between main-lobe width (resolution) and side-lobe intensity. We have extended the approach to include the interferometric phase for phase-sensitive applications like vibrometry and Doppler OCT. Using the Hann window as a reference, we show that 11 Taylor windows are sufficient to achieve 50% improvement in axial resolution, -31 dB side-lobe intensity, and 20% improvement in phase sensitivity with low computational cost.

Noncontact longitudinal shear wave imaging for the evaluation of heterogeneous porcine brain biomechanical properties using optical coherence elastography.

High-resolution quantification of heterogeneous brain biomechanical properties has long been an important topic. Longitudinal shear waves (LSWs) can be used to assess the longitudinal Young's modulus, but contact excitation methods have been used in most previous studies. We propose an air-coupled ultrasound transducer-based optical coherence elastography (AcUT-OCE) technique for noncontact excitation and detection of LSWs in samples and assessment of the nonuniformity of the brain's biomechanical properties. The air-coupled ultrasonic transducer (AcUT) for noncontact excitation of LSWs in the sample has a center frequency of 250 kHz. Phase-resolved Doppler optical coherence tomography (OCT) was used to image and reconstruct the propagation behavior of LSWs and surface ultrasound waves at high resolution. An agar phantom model was used to verify the feasibility of the experimental protocol, and experiments with ex vivo porcine brain samples were used to assess the nonuniformity of the brain biomechanical properties. LSWs with velocities of 0.83 ± 0.11 m/s were successfully excited in the agar phantom model. The perivascular elastography results in the prefrontal cortex (PFC) of the ex vivo porcine brains showed that the Young's modulus was significantly higher in the longitudinal and transverse directions on the left side of the cerebral vessels than on the right side and that the Young's modulus of the PFC decreased with increasing depth. The AcUT-OCE technique, as a new scheme for LSW applications in in vivo elastography, can be used for noncontact excitation of LSWs in brain tissue and high-resolution detection of heterogeneous brain biomechanical properties.

Long-Term Effects on Retinal Structure and Function in a Mouse Endothelin-1 Model of Retinal Ganglion Cell Degeneration.

To study the long-term effects of endothelin-1 (ET-1)-induced retinal pathologies in mouse, using clinically relevant tools. Adult C57BL/6 mice (7-9 weeks old) were intravitreally injected with PBS (n = 10) or 0.25 (n = 8), 0.5 (n = 8), or 1 nmol ET-1 (n = 9) and examined using electroretinogram, optical coherence tomography (OCT), and Doppler OCT at baseline and postinjection days 10, 28, and 56. Retinal ganglion cell (RGC) survival in retinal whole mount was quantified at days 28 and 56. ET-1 induced immediate retinal arterial constriction. The significantly reduced total blood flow and positive scotopic threshold response in the 0.5- and 1-nmol ET-1 groups at day 10 were recovered at day 28. A-wave magnitude was also significantly reduced at days 10 and 28. While a comparable and significant reduction in retinal nerve fiber layer thickness was detected in all ET-1 groups at day 56, the 1-nmol group was the earliest to develop such change at day 28. All ET-1 groups showed a transient inner retinal layer thinning at days 10 and 28 and a plateaued outer layer thickness at days 10 to 56. The 1-nmol group showed a significant RGC loss over all retinal locations examined at day 28 as compared with PBS control. As for the lower-dosage groups, significant RGC density loss at central and midperipheral retina was detected at day 56 when compared with day 28. ET-1 injection in mice resulted in a transient vascular constriction and reduction in retinal functions, as well as a gradual loss of retinal nerve fiber layer and RGC in a dose-dependent manner.

Multi-Contrast Jones-Matrix Optical Coherence Tomography—The Concept, Principle, Implementation, and Applications

Jones-matrix optical coherence tomography (JM-OCT) is an extension of OCT that provides multiple types of optical contrasts of biological and clinical samples. JM-OCT measures the spatial distribution of the Jones matrix of the sample and also its time sequence. All contrasts (i.e., multi-contrast OCT images) are then computed from the Jones matrix. The contrasts obtained from the Jones matrix include the conventional and polarization-insensitive OCT intensity, cumulative and local phase retardation (birefringence), degree-of-polarization uniformity quantifying the polarization randomness of the sample, signal attenuation coefficient, sample scatterer density, Doppler OCT, OCT angiography, and dynamic OCT. JM-OCT is a generalized version of OCT because it measures the generalized form of the sample information; i.e., the Jones matrix sequence. This review summarizes the basic conception, mathematical principle, hardware implementation, signal and image processing, and biological and clinical applications of JM-OCT. Advanced technical topics, including JM-OCT-specific noise correction and quantity estimation and JM-OCT's self-calibration nature, are also described.

Autocorrelation analysis-based OCT velocimetry for axial blood flow velocity imaging of the cerebral capillary network.

The accurate measurement of blood flow velocity in the capillary network is challenging due to the small size of the vessels and the slow flow of red blood cells (RBCs) within the vessel. Here, we introduce an autocorrelation analysis-based optical coherence tomography (OCT) method that takes less acquisition time to measure the axial blood flow velocity in the capillary network. The axial blood flow velocity was obtained from the phase change in the decorrelation period of the first-order field autocorrelation function (g1) of the OCT field data, which was acquired with M-mode acquisition (repeated A-scans). The rotation center of g1 in the complex plane was first re-centralized to the origin, then the phase change due to the movement of RBCs was extracted in the g1 decorrelation period which is usually 0.2-0.5 ms. In phantom experiments, the results suggest that the proposed method could accurately measure the axial speed with a wide range of 0.5-15 mm/s. We further tested the method on living animals. Compared with the phase-resolved Doppler optical coherence tomography (pr-DOCT), the proposed method can obtain robust axial velocity measurements with more than five times shorter acquisition time.

Dynamic 3D imaging of cerebral blood flow in awake mice using self-supervised-learning-enhanced optical coherence Doppler tomography

Cerebral blood flow (CBF) is widely used to assess brain function. However, most preclinical CBF studies have been performed under anesthesia, which confounds findings. High spatiotemporal-resolution CBF imaging of awake animals is challenging due to motion artifacts and background noise, particularly for Doppler-based flow imaging. Here, we report ultrahigh-resolution optical coherence Doppler tomography (µODT) for 3D imaging of CBF velocity (CBFv) dynamics in awake mice by developing self-supervised deep-learning for effective image denoising and motion-artifact removal. We compare cortical CBFv in awake vs. anesthetized mice and their dynamic responses in arteriolar, venular and capillary networks to acute cocaine (1 mg/kg, i.v.), a highly addictive drug associated with neurovascular toxicity. Compared with awake, isoflurane (2-2.5%) induces vasodilation and increases CBFv within 2-4 min, whereas dexmedetomidine (0.025 mg/kg, i.p.) does not change vessel diameters nor flow. Acute cocaine decreases CBFv to the same extent in dexmedetomidine and awake states, whereas decreases are larger under isoflurane, suggesting that isoflurane-induced vasodilation might have facilitated detection of cocaine-induced vasoconstriction. Awake mice after chronic cocaine show severe vasoconstriction, CBFv decreases and vascular adaptations with extended diving arteriolar/venular vessels that prioritize blood supply to deeper cortical capillaries. The 3D imaging platform we present provides a powerful tool to study dynamic changes in vessel diameters and morphology alongside CBFv networks in the brain of awake animals that can advance our understanding of the effects of drugs and disease conditions (ischemia, tumors, wound healing).

Measurements of cerebral microvascular blood flow, oxygenation, and morphology in a mouse model of whole-brain irradiation-induced cognitive impairment by two-photon microscopy and optical coherence tomography: evidence for microvascular injury in the cerebral white matter.

Whole-brain irradiation (WBI, also known as whole-brain radiation therapy) is a mainstay treatment modality for patients with multiple brain metastases. It is also used as a prophylactic treatment for microscopic tumors that cannot be detected by magnetic resonance imaging. WBI induces a progressive cognitive decline in ~ 50% of the patients surviving over 6months, significantly compromising the quality of life. There is increasing preclinical evidence that radiation-induced injury to the cerebral microvasculature and accelerated neurovascular senescence plays a central role in this side effect of WBI. To better understand this side effect, male C57BL/6 mice were first subjected to a clinically relevant protocol of fractionated WBI (5Gy, two doses per week, for 4weeks). Nine months post the WBI treatment, we applied two-photon microscopy and Doppler optical coherence tomography to measure capillary red-blood-cell (RBC) flux, capillary morphology, and microvascular oxygen partial pressure (PO2) in the cerebral somatosensory cortex in the awake, head-restrained, WPI-treated mice and their age-matched controls, through a cover-glass-sealed chronic cranial window. Thanks to the extended penetration depth with the fluorophore - Alexa680, measurements of capillary blood flow properties (e.g., RBC flux, speed, and linear density) in the cerebral subcortical white matter were enabled. We found that the WBI-treated mice exhibited a significantly decreased capillary RBC flux in the white matter. WBI also caused a significant reduction in capillary diameter, as well as a large (although insignificant) reduction in segment density at the deeper cortical layers (e.g., 600-700μm), while the other morphological properties (e.g., segment length and tortuosity) were not obviously affected. In addition, we found that PO2 measured in the arterioles and venules, as well as the calculated oxygen saturation and oxygen extraction fraction, were not obviously affected by WBI. Lastly, WBI was associated with a significant increase in the erythrocyte-associated transients of PO2, while the changes of other cerebral capillary PO2 properties (e.g., capillary mean-PO2, RBC-PO2, and InterRBC-PO2) were not significant. Collectively, our findings support the notion that WBI results in persistent cerebral white matter microvascular impairment, which likely contributes to the WBI-induced brain injury and cognitive decline. Further studies are warranted to assess the WBI-induced changes in brain tissue oxygenation and malfunction of the white matter microvasculature as well.

Sub-diffusion flow velocimetry with number fluctuation optical coherence tomography.

We have implemented number fluctuation dynamic light scattering optical coherence tomography (OCT) for measuring extremely slow, sub-diffusion flows of dilute particle suspensions using the second-order autocovariance function. Our method has a lower minimum measurable velocity than conventional correlation-based OCT or phase-resolved Doppler OCT, as the velocity estimation is not affected by the particle diffusion. Similar to non-dilute correlation-based OCT, our technique works for any Doppler angle. With our analysis we can quantitatively determine the concentration of particles under flow. Finally, we demonstrate 2D sub-diffusion flow imaging with a scanning OCT system at high rate by performing number fluctuation correlation analysis on subsequent B-scans.

Development of Intraoperative Robotic System “RMA-OCDS” Diagnosing Early OA based on Doppler OCT

Development of Intraoperative Robotic System “RMA-OCDS” Diagnosing Early OA based on Doppler OCT

Retinal blood flow and oxygen metabolism in diabetes

AbstractDiabetic retinopathy is the leading cause for blindness in the Western countries and its prevalence is constantly increasing. In the last years, evidence has accumulated that alterations in the retinal microcirculation and changes in retinal oxygen metabolism play a key role in the disease process. In particular, tissue hypoxia seems to be a major trigger of neovascularization and macular edema in the retina of patients with diabetes.Recently, new methods to assess the retinal vasculature, such as Doppler Optical Coherence Tomography (OCT) or OCT angiography have become available, providing valuable findings in patients with diabetes. Combining these methods with techniques such as the assessment of retinal oxygen saturation, more information about retinal oxygen metabolism can be obtained.The present talk will summarize the current knowledge on retinal blood flow and oxygen metabolism in patients with diabetes.Acknowledgements: Part of the work presented was funded by the Austrian Science Fund (FWF), Projects No. KLI 721 and P26157.

Neuro-vascular coupling and heart rate variability in patients with type II diabetes at different stages of diabetic retinopathy.

There is evidence that diabetes is accompanied by a break-down of functional hyperemia, an intrinsic mechanism of neural tissues to adapt blood flow to changing metabolic demands. However, to what extent functional hyperemia is altered in different stages of diabetic retinopathy (DR) in patients with type II diabetes is largely unknown. The current study set out to investigate flicker-induced retinal blood flow changes in patients with type II diabetes at different stages of DR. A total of 76 subjects were included in the present parallel-group study, of which 56 had diabetes with either no DR or different stages of non-proliferative DR (n = 29 no DR, 12 mild DR, 15 moderate to severe DR). In addition, 20 healthy subjects were included as controls. Retinal blood flow was assessed before and during visual stimulation using a combined measurement of retinal vessel calibers and blood velocity by the means of Doppler optical coherence tomography (OCT). To measure systemic autonomic nervous system function, heart rate variability (HRV) was assessed using a short-term orthostatic challenge test. In healthy controls, retinal blood flow increased by 40.4 ± 27.2% during flicker stimulation. Flicker responses in patients with DR were significantly decreased depending on the stage of the disease (no DR 37.7 ± 26.0%, mild DR 26.2 ± 28.2%, moderate to severe DR 22.3 ± 13.9%; p = 0.035, ANOVA). When assessing systemic autonomous neural function using HRV, normalized low frequency (LF) spectral power showed a significantly different response to the orthostatic maneuver in diabetic patients compared to healthy controls (p < 0.001). Our study indicates that flicker induced hyperemia is reduced in patients with DR compared to healthy subjects. Further, this impairment is more pronounced with increasing severity of DR. Further studies are needed to elucidate mechanisms behind the reduced hyperemic response in patients with type II diabetes. [https://clinicaltrials.gov/], identifier [NCT03 552562].

Review of intraluminal optical coherence tomography imaging for cerebral aneurysms

Cerebral aneurysms are an abnormal ballooning of blood vessels which have the potential to rupture and cause hemorrhagic stroke. The diagnosis, treatment, and monitoring of cerebral aneurysms is highly dependant on high resolution imaging. As an imaging modality capable of cross-sectional resolution down to 10 μm, intraluminal optical coherence tomography (OCT) has great potential in improving care for cerebral aneurysms. The ability to assess the blood vessel microanatomy in vivo may be able to predict aneurysm growth and rupture. During treatment, intraluminal OCT may aid in assessment of treatment efficacy and complication avoidance, such as via visualization of in-stent thrombosis, stent wall apposition, and the fate of covered branch vessels. This technology can also be used in post-treatment monitoring, to assess for aneurysmal remnants or for endothelialisation and healing over the diseased segments. The goal of this clinically focused narrative review is to provide an overview of the previous applications of intraluminal OCT in cerebral aneurysms and future prospects of applying this technology to improve care in patients with cerebral aneurysms, including a specific neurovascular OCT catheter, doppler OCT for high resolution blood flow assessment, and further research endeavors.

Glaucoma Diagnostic Performance of Retinal Blood Flow Measurement With Doppler Optical Coherence Tomography.

PurposeThe purpose of this study was to evaluate the diagnostic performance of retinal blood flow (RBF) measured with the Doppler optical coherence tomography (OCT) segmental scanning method to distinguish between healthy and glaucoma eyes.MethodsFifty-eight patients with normal tension glaucoma (NTG) who had a single-hemifield visual field defect and 44 age-matched healthy subjects were enrolled. Retinal nerve fiber layer thickness (RNFLT) was measured with swept-source OCT. Superior and inferior temporal arteries (TAs) and temporal veins (TVs) RBF were measured with Doppler OCT. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to compare the diagnostic performances in the damaged and normal hemispheres.ResultsMultivariate regression analysis showed TA RBF and TV RBF were significantly reduced in the damaged and normal hemispheres. The ROC analysis showed that the AUC for quadrant RNFLT, TA RBF, and TV RBF were 0.973, 0.909, and 0.872 in the damaged hemisphere, respectively. The AUC values in the normal hemisphere were 0.783, 0.744, and 0.697, respectively. The combination of quadrant RNFLT and TA/TV RBF had a greater AUC than quadrant RNFLT alone in both damaged (AUC = 0.987) and normal (AUC = 0.825) hemispheres.ConclusionsIn NTG eyes with single-hemifield damage, the RBF was found to be significantly reduced in the damaged and normal hemispheres independent from structural changes. The combination of RNFLT and RBF could improve diagnostic performances for glaucoma.Translational RelevanceCombining morphological and blood flow measurements with Doppler OCT may be useful in glaucoma diagnosis.

Retinal Oxygen Metabolism in Patients With Type 2 Diabetes and Different Stages of Diabetic Retinopathy.

The aim of this cross-sectional study was to assess retinal oxygen metabolism in patients with type 2 diabetes and different stages of nonproliferative diabetic retinopathy (DR) (n = 67) compared with healthy control subjects (n = 20). Thirty-four patients had no DR, 15 had mild DR, and 18 had moderate to severe DR. Retinal oxygen saturation in arteries and veins was measured using the oxygen module of a retinal vessel analyzer. Total retinal blood flow (TRBF) was measured using a custom-built Doppler optical coherence tomography system. Retinal oxygen extraction was calculated from retinal oxygen saturation and TRBF. Arteriovenous difference in oxygen saturation was highest in healthy subjects (34.9 ± 7.5%), followed by patients with no DR (32.5 ± 6.3%) and moderate to severe DR (30.3 ± 6.5%). The lowest values were found in patients with mild DR (27.3 ± 8.0%, P = 0.010 vs. healthy subjects). TRBF tended to be higher in patients with no DR (40.1 ± 9.2 μL/min) and mild DR (41.8 ± 15.0 μL/min) than in healthy subjects (37.2 ± 5.7 μL/min) and patients with moderate to severe DR (34.6 ± 10.4 μL/min). Retinal oxygen extraction was the highest in healthy subjects (2.24 ± 0.57 μL O2/min), followed by patients with no DR (2.14 ± 0.6 μL O2/min), mild DR (1.90 ± 0.77 μL O2/min), and moderate to severe DR (1.78 ± 0.57 μL O2/min, P = 0.040 vs. healthy subjects). These results indicate that retinal oxygen metabolism is altered in patients with type 2 diabetes. Furthermore, retinal oxygen extraction decreases with increasing severity of DR.