Biology subjects

Kashani, A. H.

Publications and source records attributed to Kashani, A. H..

3 recordsLinked to original sources

bioRxiv2020

Impaired Layer Specific Retinal Vascular Reactivity Among Diabetic Subjects

PurposeTo investigate layer specific retinal vascular reactivity (RVR) in capillaries of diabetic subjects with no or mild non-proliferative diabetic retinopathy (NPDR). MethodsA previously described nonrebreathing apparatus was used to deliver room air, 5% CO2, or 100% O2 to 41 controls and 22 diabetic subjects (with mild or no NPDR) while simultaneously acquiring fovea-centered 3x3mm2 Swept-Source Optical Coherence Tomography Angiography. Vessel skeleton density (VSD) and vessel diameter index (VDI) were calculated for each gas condition for the superficial retinal layer (SRL) and deep retinal layer (DRL). The superficial layer analysis excluded regions of arterioles and venules. Data analysis was performed using mixed factorial analysis of covariance stratified by diabetic status. All models were adjusted for age, gender, and hypertension. ResultsAmong controls, there was a significant difference in capillary VSD between all gas conditions (p<0.001). This difference was present in both the SRL and DRL. Among diabetics, there was no significant difference in response to CO2 conditions in the SRL (p=0.072), and a blunted response to both CO2 and O2 in the DRL. A significant gas effect was detected in the capillary VDI in the SRL of controls (p=0.001), which was driven by higher VDI in the oxygen condition compared to that of carbon dioxide. ConclusionsImpairment in RVR in diabetic subjects is driven largely by a decrease in the magnitude of the capillary response to O2 in the DRL as well as almost complete attenuation of capillary CO2 response in all layers. These layer and gas specific impairments in diabetics seem to occur early in the disease and to be driven primarily at the capillary level.

physiology↗

bioRxiv2019

Quantifying subclinical and longitudinal microvascular changes following episcleral plaque brachytherapy (EPB) using spectral-domain OCT angiography.

BackgroundI-125 episcleral plaque brachytherapy (EPB) is standard-of-care for globe-conserving treatment of medium-sized choroidal melanomas. Radiation retinopathy is a potential consequence of treatment, characterized by deleterious effects on retinal microvasculature. We investigated the application of Optical Coherence Tomography Angiography (OCTA) for detecting and longitudinally monitoring I-125 episcleral plaque brachytherapy induced radiation retinopathy. MethodsHigh resolution OCTA of the central 3x3mm macula were obtained from I-25 episcleral plaque brachytherapy treated and untreated fellow eyes of 62 patients. Capillary density (vessel skeleton density, VSD) and caliber (vessel diameter index, VDI) were quantified using previously validated semi-automated algorithms. Nonperfusion was also quantified as flow impairment regions (FIR). Exams from treated and fellow eyes obtained pre-treatment and at 6-month, 1-year, and 2-year intervals were compared using generalized estimating equation linear models. Dosimetry maps were used to evaluate spatial correlation between radiation dose and microvascular metrics. ResultsMean time from treatment to last follow-up was 10.8 months. Mean{+/-}SD and median radiation dose at the fovea were 64.5 {+/-} 76 Gy and 32.0 Gy, respectively. Preoperative logMAR (Snellen) mean visual acuity was 0.26 {+/-} 0.05 ([~]20/35) and 0.08 {+/-} 0.02 ([~]20/25) in treated and fellow eyes, respectively. At 6 months, treated eyes had significantly lower VSD (0.147 {+/-} 0.003 vs 0.155 {+/-} 0.002; p = 0.023) and higher FIR (1.95 {+/-} 0.176 vs 1.45 {+/-} 0.099; p = 0.018) compared to fellow eyes. There was a significant decrease in VSD and a corresponding increase in FIR even for treated eyes without clinically identifiable retinopathy at 6 months. VDI was significantly higher in treated eyes than in fellow eyes at 2 years (2.93 {+/-} 0.022 vs 2.84 {+/-} 0.016; p = 0.002). Microvascular changes were spatially correlated with a radiation gradient of 85-250 Gy across the fovea. ConclusionsOCTA can be used to quantify and monitor EPB induced radiation, and can detect vascular abnormalities even in the absence of clinically observable retinopathy. OCTA may therefore be useful in investigating treatment interventions that aim to delay EPB-induced radiation retinopathy.

scientific communication and education↗

bioRxiv2019

An Automated 3D Analysis Framework for Optical Coherence Tomography Angiography

Optical Coherence Tomography Angiography (OCTA) is a novel, non-invasive imaging modality of retinal capillaries at micron resolution. While OCTA generates 3D image volumes, current analytic methods rely on 2D en face projection images for quantitative analysis. This obscures the 3D vascular geometry and prevents accurate characterization of retinal vessel networks. In this paper, we have developed an automated analysis framework that preserves the 3D geometry of OCTA data. This framework uses curvelet-based denoising, optimally oriented flux (OOF) vessel enhancement and projection artifact removal, as well as the generation of 3D vessel length from the Hamilton-Jacobi skeleton. We implement this method on a dataset of 338 OCTA scans from human subjects with diabetic retinopathy (DR) which is known to cause decrease in capillary density and compare them to healthy controls. Our results indicate that 3D vessel-skeleton-length (3D-VSL) captures differences in both superficial and deep capillary density that are not apparent in 2D vessel skeleton analyses. In statistical analysis, we show that the 3D small-vessel-skeleton-length (3D-SVSL), which is computed after the removal of the large vessels and associated projection artifacts, provides a novel metric to detect group differences between healthy controls and progressive stages of DR.\n\nThis work was supported in part by NIH grants UH3NS100614, R21EY027879, U01EY025864, K08EY027006, P41EB015922, P30EY029220, Research to Prevent Blindness, and UL1TR001855 and UL1TR000130 from the National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health.

bioengineering↗