Abstract An animal experiment had been conducted for the purpose to find out the possibility of application of instantaneous sustained limited expansion (ISLE). A total of 54 skin defects in 9 pigs were obtained and were divided into two groups. One group of the pigs were subjected to instantaneous sustained limited expansion, the others, as the control group, just received the tension suture. At the same time the blood supply of the skin was measured by laser doppler flowmeter (LDF). It was showed that microcirculatory perfusion of the ISLE group was considerably better than that of the control. Inaddition, the correlation between the blood flow of the skin and the expanding pressure, as well as the pathologic changes of the skin were discussed.
ObjectiveTo compare the fast blood flow density (FBFD) of intermediate choroid between endogenous Cushing syndrome (ECS) patients and healthy control subjects.MethodsThirteen eyes of 7 eligible ECS patients (ECS group) and 13 eyes of 7 gender, age, axial length matched healthy volunteers (control group) were enrolled in this study. For each subject, macular radial scan with swept source optical coherence tomography (SS-OCT) was performed and subfoveal choroidal thickness (SCT) was measured. Then 3.0 mm×3.0 mm macular scan with SS-OCT angiography was performed, and selected blood flow image at intermediate choroid level or 1/2 SCT beneath Bruch membrane. The grayscale images were then binarized for the analysis of FBFD.ResultsThe SCT in ECS group was (394.7±77.7) μm, which was significantly thicker than (332.1±68.1) μm in control group (t=2.923, P=0.008). The FBFD of intermediate choroid in ECS group were (76.35±14.46)%, which were significantly greater than (63.57±13.42)% in control group (t=2.775, P=0.01).ConclusionECS patients had increased FBFD at intermediate choroid level compared with healthy controls.
ObjectiveTo observe the changes of choroidal capillary flow area (CBFA) and density in patients with idiopathic macular hole (IMH) before and after surgery.MethodsA prospective clinical study. Thirty patients (60 eyes) with unilateral IMH diagnosed in Department of Ophthalmology of The Second Hospital of Hebei Medical University from February 2017 to March 2018 and 30 age-and sex- matched normal controls were included in this study. All eyes were divided into group A (30 affected eyes), group B (30 fellow eyes) and group C (30 normal eyes of controls). Among 30 eyes in group A, there were 5, 14, 11 eyes with hole in stage Ⅱ, Ⅲ, Ⅳ, respecitvely. The eyes in group A were divided into two subgroups according to the diameter of the holes: group D: hole diameter less than or equal to 500 μm (11 eyes), group E: hole diameter over than 500 μm (19 eyes). All eyes in group A underwent vitrectomy. Spectral-domain OCT was used to observe the diameter size of macular hole and the closure of the hole after vitrectomy in eyes of group A. The CBFA and blood flow density of superficial choroidal capillaries were measured by OCT angiography before and 3 months after vitrectomy in groups A, B and C. Univariate analysis of variance and t test were used for statistical analysis.ResultsBefore surgery, in group A, B and C, the CBFA were 2.84±0.35, 3.19±0.23, 3.26±0.24 mm2, the blood flow density were (20.74±8.26)%, (35.18±5.20)%, (35.20±6.49)%, respectively. The CBFA and blood flow density in group A were significantly lower than those in group B and C (F=19.768, 45.583; P = 0.000, 0.000), but there was no significant difference between group B and C (F=19.768, 45.583; P=0.332, 0.994). The CBFA and blood flow density in group D were higher than those in group E (t=2.230, 2.202; P=0.034, 0.036). The diameter of macular hole was negatively correlated with CBFA and blood flow density (r=－0.377, －0.477; P=0.044, 0.009). Three months after surgery, the macular holes in group A were closed; CBFA and blood flow density in macular area were significantly higher than before surgery (t=－4.126, －4.912; P=0.000, 0.000).ConclusionsCBFA and blood flow density decreased in the macular area of IMH. CBFA and blood flow density can be recovered after vitrectomy.
ObjectiveTo observe the multimodal imaging characteristics of tamoxifen retinopathy. MethodsA retrospective case study. From January 2019 to December 2021, 4 patients (8 eyes) with tamoxifen retinopathy diagnosed in Tangshan Eye Hospital were included in the study. All patients were female, with sick binoculus. The age was 59.5±4.6 years. After breast cancer resection, tamoxifen 20 mg/d was taken orally consecutively, including 1, 1, and 2 cases who took tamoxifen orally for 5, 7, and ≥10 years. All eyes were examined by fundus color photography, optical coherence tomography (OCT), OCT angiography (OCTA), fundus fluorescein angiography (FFA), and fundus autofluorescence (AF). The multi-mode image features of the fundus of the affected eyes were observed. ResultsThe yellow white dot crystal like material deposition in the macular area was observed in all eyes. In fundus AF examination, macular area showed patchy strong AF. FFA examination showed telangiectasia and fluorescein leakage in macular area at late stage. OCT showed that punctate strong reflexes could be seen between the neuroepithelial layers in the macular region with the formation of a space between the neuroepithelial layers, the interruption of the elliptical zone (EZ), and the formation of a hole in the outer lamella including 4, 5 and 3 eyes; The thickness of ganglion cells in macular region decreased in 7 eyes. OCTA showed that the blood flow density of the superficial retinal capillary plexus around the arch ring was decreased, and the retinal venules were dilated in 2 eyes; Deep capillary plexus (DCP) showed telangiectasia. ConclusionDeposition of yellowish white dot like crystals can be seen in the macular region of tamoxifen retinopathy; dotted strong reflex between neuroepithelial layers, cavity formation, thinning of ganglion cell layer, EZ middle fissure and outer lamellar fissure; DCP capillaries and venules around the arch were dilated; telangiectasia in macular region; flaky strong AF in macular region.
ObjectiveTo observe the value of optical coherence tomography (OCTA) in distinguishing ischemic and non-ischemic branch retinal vein occlusion (BRVO). MethodsA prospective clinical observational study. From January 2020 to January 2021, 44 eyes of 44 patients with BRVO diagnosed in Tianjin Medical University Eye Hospital were included in the study. Among them, there were 24 eyes of 24 males and 20 eyes of 20 females. The macular edema subsided after three consecutive anti-vascular endothelial growth factor (VEGF) drug treatments. All the affected eyes underwent best corrected visual acuity (BCVA), intraocular pressure, ultra-wide-angle fluorescein fundus angiography (UWFFA), and OCTA examination. According to the results of UWFFA, the affected eyes were divided into ischemic group and non-ischemic group, with 22 eyes in 22 patients. The macular area of the affected eye with an OCTA instrument were scaned in the range of 3 mm×3 mm to measure the blood flow density (SVD, DVD), foveal blood flow density (SFVD, DFVD), parafoveal blood flow density (SPFVD, DPFVD), affected hemilateral blood flow density (SHVD, DHVD) and affected quadrant blood flow density (SQVD, DQVD) of the superficial capillary layer (SCP) and deep capillary layer (DCP) of the retina, foveal retinal thickness (CRT), fovea avascular zone (FAZ) area, perimeter of FAZ (PERIM), out-of-roundness index (AI), and blood flow density within 300 μm width of FAZ (FD-300). The two-sample independent t test was used to compare the parameters between the ischemic group and the non-ischemic group. Receiver operating characteristic (ROC) curve analysis was used to measure the area under the curve (AUC) of blood flow density to predict ischemic BRVO, determine the critical value for predicting ischemic BRVO and the corresponding sensitivity and specificity, with AUC＞0.9 as the prediction performance was good. ResultsThe differences of BCVA (t=1.544), intraocular pressure (t=－0.404), SFVD (t=0.444), DFVD (t=－0.812), CRT (t=1.082), FAZ area (t=－0.785), PERIM (t=－0.685), AI (t=1.047) of the eyes in the ischemic group and non-ischemic group were not statistically significant (P＞0.05). The differences of age (t=2.194), SVD (t=－3.796), SPFVD (t=－4.181), SHVD (t=－4.700), SQVD (t=－3.594), DVD (t=－2.324), DPFVD (t=－2.476), DHVD (t=－2.118), DQVD (t=－6.529) and FD-300 (t=－5.116) of the eyes in the ischemic group and non-ischemic group area were statistically significant (P＜0.05). ROC curve analysis results showed that DQVD predicted the AUC of ischemic BRVO the largest (0.917), the best cut-off value was 33.75%, and the sensitivity and specificity were 90.9% and 81.8%, respectively. ConclusionOCTA can quantitatively assess the microvascular structure of SCP and DCP in the macular area of BRVO eyes, and contribute to distinguish ischemic and non-ischemic BRVO.
ObjectTo evaluate the feasibility of measuring the descending aortic blood flow using transesophageal ultrasound Doppler under cardiopulmonary bypass (CPB). MethodWe retrospectively analyzed the clinical data of 10 adult patients accepted elective cardiac surgery under CPB in March 2014 year. There were 4 males and 6 females with a mean age of 44.5±12.3 years ranging from 24.5-64.0 years. The descending aorta diameter and velocity time integral (VTI) of blood flow of middle esophageal and lower esophageal of these patients were detected by transesophageal echocardiography (TEE) under CPB. We took the formula of classic ultrasound texting the blood flow to calculate the descending aorta blood flow (DABF). At the same time, we recorded the data of CPB and index of hemodynamics. Compared with the flow of CPB pump, we analyzed the correlation between pump flow and the raliability of DABF texting value under CPB. ResultsTwo patients quit the trail for blurred imaging. The quality of blood flow spectrum images aquirded from the middle esophageal were inferior to those from the lower esophageal (P < 0.01) in the 10 patients. Among the patients 90% of DABF from the middle esophageal and 50% of DABF from the lower esophageal were more than pump flow. however, the texting value had an excellence correlation to PF (r=0.795, r=0.825). ConclusionThe classical TEE technique can not obtain accurate blood flow during CPB.
ObjectiveTo observe the alterations of microvascular structure in patients with macular edema (ME) associated with branch retinal vein occlusion (BRVO) before and after anti-VEGF drug therapy.MethodsA retrospective case study. Thirty-two eyes of 32 patients with unilateral BRVO-ME at Department of Ophthalmology in Beijing Hospital during November 2016 to June 2018 were enrolled in this study. There were 14 males (14 eyes) and 18 females (18 eyes), with the mean age of 57.81±10.58 years, and the mean course of the disease of 12.13±7.13 d. The affected eyes was defined as the eyes with BRVO-ME. All the affected eyes received intravitreal anti-VEGF drug injections (3+PRN). BCVA and OCT angiography (OCTA) were performed on the BRVO and fellow eyes before and after intravitreal anti-VEGF drug injections. The scanning region in the macular area was 3 mm×3 mm. Macular blood flow density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), macular hemodynamics parameters [foveal avascular area (FAZ) area, perimeter (PERIM), acircularity index (AI) and vessel density within a 300um width ring surrounding the FAZ (FD-300)] and central retinal thickness (CRT) were measured in all eyes. Paired samples t-test and Univariate Linear Regression were used in this study.ResultsComparing with fellow eyes, the mean macular blood flow density measured in the entire scan was lower in BRVO-ME eyes in the SCP (t=6.589, P=0.000) and DCP (t=9.753, P=0.000), PERIM (t=4.054, P=0.000) ), AI enlarged in BRVO-ME eyes (t=4.988, P=0.000), FD-300 was lower in BRVO-ME eyes (t=2.963, P=0.006), FAZ area enlarged in BRVO-ME eyes (t=0.928, P=0.361). The blood flow density in the DCP was the parameter most significantly correlated with BCVA and FAZ area (r=0.462, −0.387;P＜ .05). After 3 intravitreal injections of anti-VEGF drug, the CRT and FD-300 decreased, BCVA increased (t=9.865, 3.256, −10.573; P＜0.05), PERIM and AI was not changed significantly (t=0.520, 2.004; P＞0.05). The blood flow density in the SCP decreased (t=2.814, P＜0.05), but the blood flow density in the DCP was not changed significantly (t=0.661, P=0.514). Contrarily, comparing with after 1 anti-VEGF drug injection, the blood flow density in the DCP increased after 2 anti-VEGF drug injections (t=3.132, P＜0.05). FAZ area enlarged in BRVO-ME eyes (t=5.340, P＜0.001). Comparing with last anti-VEGF drug injection, FAZ area enlarged after every anti-VEGF drug injection (t=2.907, 3.742, 2.203; P＜0.05).ConclusionsIn BRVO-ME eyes, the blood flow density in the SCP and DCP are decreased. The blood flow density in the DCP is positively correlated with BCVA and negatively correlated with FAZ area. After anti-VEGF drug therapy, the blood flow density is decreased in the SCP and increased in the DCP, FAZ area enlarged gradually, PERIM and AI are not changed significantly.
Objective To investigate the long effect of nonpulsatile flow on changes of structure and function in pulmonary microcirculation and to identify the pulmonary reconstruction under this blood perfusion. Methods Canine models with nonpulsatile flow in the right lung was established, and sacrificed 6 months later. Compare endothelial nitric oxide synthase (eNOS) in vascular endothelium, apoptosis in smooth muscle cell with immunohistochemistry by streptavidinbioepidermmultienzyme complex methodes, and observe structural changes in pulmonary arterioles with optical microscope. Results The expression of eNOS in the right nonpulsatile flow perfusing lung was weaker as compared to the left lung （10 846.7±177.8 vs. 13 136.1±189.6;t＝2.240, P=0.040）, the fas was ber as compared to the left lung（14 254.1±217.1 vs. 11 976.7±195.7; t＝2.160, P=0.040）. The ratio of wall thichness/vessel diameter in the right lung（13.64%±12.80% vs. 14.96%±13.10%） and wall area/vessel area(46.40%±11.70% vs. 47.80%±12.20%) was lower as compared to the left lung(Plt;0.05). Conclusion Longterm nonpulsatile flow can decrease the expression of eNOS, contract the muscles in capillary net, and increase pulmonary vascular resistance. Moreover it canincrease the arteriole apoptosis, leading to vascular structure remodeling.
In order to study effect of endothelin (ET-1) on hepatic blood flow in rats and effect of nitric oxide (NO) and prostacyclin (PGI2) on ET-1 biological function, 20 rats were randomized into control, ET-1, ET-1 plus nitric-Larginine, ET-1 plus prostacyclin and indomethen groups. The result showed that ET-1 decreased hepatic blood flow and lasted for longer time. NO and PGI2 may antagonize the biological action of ET-1 during endotoxemia. Therefore, the endothelium-derived vascular factors may regulate hepatic blood flow.
ObjectiveTo observe the changes of retinal and choroidal blood flow density and thickness in macula of different myopic dioptre eyes, and to analyze the correlation between retinal and choroidal blood flow density and axial length (AL). MethodsA retrospective clinical study. From October 2022 to May 2023, 86 eyes of 56 myopic patients scheduled for refractive surgery in Department of Ophthalmology, PLA Central Theater CommandGeneral were included into the study. According to the equivalent spherical specular degree (SE), 19, 21, 27 and 19 eyes of low myopia group (group A), moderate myopia group (group B), high myopia group (group C) and super high myopia group (group D) were observed. Optical coherence tomography angiography (OCTA) and AL measurement were performed in all patients. The diopter was expressed in SE. AL was measured by ultrasonic bio-meter. OCTA scanner was used to scan the macular region in the range of 3 mm × 3 mm. The software automatically divided the macular region into two concentric circles with the fovea as the center, which were 1 mm in diameter respectively, the paracentric fovea of 1-3 mm was divided into 5 regions: superior, nasal, inferior and temporal. The superficial capillary plexus (SCP), deep capillary plexus (DCP), choroidal capillary plexus (CC), choroidal blood flow density, retinal and choroidal thickness were measured. The correlation between AL and blood flow density and thickness was analyzed by Pearson correlation analysis. ResultsThere was no significant difference in SCP blood density and DCP blood density in the fovea in groups A, B, C and D (P＞0.05) .There were significant differences in DCP flow density among superior, nasal, inferior and temporal areas (P＜0.05), the difference was significant (P＜0.05). There was no significant difference in the fovea area between the four groups (P＞0.05), but there was significant difference in the superior, nasal, inferior and temporal areas (P＜0.05). Different macular regions: there were statistically significant among group A, group B, and group C, group D (P＜0.05). Results of correlation analysis, AL was negatively correlated with DCP blood flow density (r=−0.504, −0.500, −0.460, −0.465), retinal thickness (r=−0.348, −0.338, −0.312, −0.230), macular subarea CC (r=−0.633, −0.666, −0.667, −0.710, −6.82), choroidal layer (r=−0.635, −0.687, −0.659, −0.703, −0.680) and choroidal thickness (r=−0.665, −0.605, −0.656, −0.648, −0.643) (P＜0.05). ConclusionsAL is negatively correlated with DCP, CC, CDF, retinal and choroidal thickness in the eyes with myopia. SCP, DCP and retinal thickness in fovea did not change significantly, and temporal choroidal thickness changed earlier than other areas.