Measurement of retinal blood flow in normal Chinese-American subjects by Doppler Fourier-domain optical coherence tomography.

PURPOSE To measure total retinal blood flow (TRBF) in normal, healthy Chinese Americans by using semi-automated analysis of Doppler Fourier-domain optical coherence tomography (FD-OCT) scans. METHODS Two hundred sixty-six normal, healthy Chinese-American participants (266 eyes) were enrolled from The Chinese American Eye Study. All participants underwent complete ophthalmic examination, including best-corrected visual acuity, indirect ophthalmoscopy, and Doppler FD-OCT imaging, using the circumpapillary double circular scan protocol. Total retinal blood flow and other vascular parameters (e.g., venous and arterial cross-sectional area and their velocities) were calculated by using Doppler OCT of Retinal Circulation software. Associations between TRBF and other clinical parameters were assessed by using bivariate correlations and linear regression. RESULTS The mean age of study participants was 57.40 ± 5.60 (range, 50-82) years. The mean TRBF was 49.34 ± 10.08 (range, 27.17-78.08, 95% confidence interval: 25.98-69.10) μL/min. The mean venous area was 0.0548 (±0.0084) mm(2). Superior retinal hemispheric blood flow (25.50 ± 6.62 μL/min) was slightly greater than inferior retinal hemispheric blood flow (23.84 ± 7.19 μL/min, P = 0.008). The mean flow velocity was 15.16 ± 3.12 mm/s. There was a weak but significant negative correlation between TRBF and age (r = -0.15, P = 0.012). No significant correlation was found between TRBF and axial length (r = 0.11, P = 0.08). Retinal blood flow was not significantly correlated with any other clinical parameters, including body mass index, systolic blood pressure, diastolic blood pressure, and intraocular pressure. CONCLUSIONS Normal Doppler OCT-derived total retinal blood values in a Chinese-American population showed considerable variability, some of which was explained by age. These observations should help design future studies evaluating TRBF in populations with eye disease.

[1]  Barry Cense,et al.  In vivo dynamic human retinal blood flow imaging using ultra-high-speed spectral domain optical coherence tomography. , 2003, Optics express.

[2]  H. Littmann [Determining the true size of an object on the fundus of the living eye]. , 1988, Klinische Monatsblatter fur Augenheilkunde.

[3]  J. Schuman,et al.  Optical coherence tomography. , 2000, Science.

[4]  E. Stefánsson,et al.  The impact of ocular blood flow in glaucoma , 2002, Progress in Retinal and Eye Research.

[5]  David Huang,et al.  Relationship among visual field, blood flow, and neural structure measurements in glaucoma. , 2012, Investigative ophthalmology & visual science.

[6]  Richard B. Rosen,et al.  Retinal Blood Flow in the Normal Human Eye Using the Canon Laser Blood Flowmeter , 2002, Ophthalmic Research.

[7]  K. Wright Textbook of ophthalmology , 1997 .

[8]  Joseph A. Izatt,et al.  Doppler velocity detection limitations in spectrometer-based versus swept-source optical coherence tomography , 2011, Biomedical optics express.

[9]  E. Newman,et al.  Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease , 2012, Progress in Retinal and Eye Research.

[10]  David Huang,et al.  Retinal blood flow detection in diabetic patients by Doppler Fourier domain optical coherence tomography. , 2009, Optics express.

[11]  J. Izatt,et al.  Retinal blood flow measurement by circumpapillary Fourier domain Doppler optical coherence tomography. , 2008, Journal of biomedical optics.

[12]  A Hofman,et al.  Age-specific prevalence and causes of blindness and visual impairment in an older population: the Rotterdam Study. , 1998, Archives of ophthalmology.

[13]  J. Nelson,et al.  Characterization of fluid flow velocity by optical Doppler tomography. , 1995, Optics letters.

[14]  R W Flower,et al.  Extraction of choriocapillaris hemodynamic data from ICG fluorescence angiograms. , 1993, Investigative ophthalmology & visual science.

[15]  B L Petrig,et al.  Blood velocity and volumetric flow rate in human retinal vessels. , 1985, Investigative ophthalmology & visual science.

[16]  J. Jonas,et al.  Retinal vein occlusions. , 2010, Developments in ophthalmology.

[17]  J. Izatt,et al.  In vivo bidirectional color Doppler flow imaging of picoliter blood volumes using optical coherence tomography. , 1997, Optics letters.

[18]  A. Harris,et al.  The role of optic nerve blood flow in the pathogenesis of glaucoma. , 2005, Ophthalmology clinics of North America.

[19]  Joseph A Izatt,et al.  In vivo total retinal blood flow measurement by Fourier domain Doppler optical coherence tomography. , 2007, Journal of biomedical optics.

[20]  Teresa C. Chen,et al.  In vivo dynamic human retinal blood flow imaging using ultra-high-speed spectral domain optical Doppler tomography , 2003 .

[21]  G. Michelson,et al.  Influence of age on retinal and optic nerve head blood circulation. , 1996, Ophthalmology.

[22]  Shuichi Makita,et al.  Quantitative retinal-blood flow measurement with three-dimensional vessel geometry determination using ultrahigh-resolution Doppler optical coherence angiography. , 2008, Optics letters.

[23]  Joseph A Izatt,et al.  Pilot study of optical coherence tomography measurement of retinal blood flow in retinal and optic nerve diseases. , 2011, Investigative ophthalmology & visual science.

[24]  Leopold Schmetterer,et al.  Doppler Optical Coherence Tomography , 2014, Progress in Retinal and Eye Research.

[25]  F W Fitzke,et al.  Measurement of optic disc size: equivalence of methods to correct for ocular magnification , 1998, The British journal of ophthalmology.

[26]  Carmen A. Puliafito,et al.  Automatic retinal blood flow calculation using spectral domain optical coherence tomography , 2007 .

[27]  Maciej Wojtkowski,et al.  Real-time measurement of in vitro flow by Fourier-domain color Doppler optical coherence tomography. , 2004, Optics letters.

[28]  J. Fujimoto,et al.  Optical coherence tomography of the human retina. , 1995, Archives of ophthalmology.

[29]  David Huang,et al.  Reproducibility of retinal blood flow measurements derived from semi-automated Doppler OCT analysis. , 2011, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[30]  W. Lee,et al.  Age-related retinal vasculopathy , 1987, Eye.

[31]  T. Duong,et al.  Blood flow MRI of the human retina/choroid during rest and isometric exercise. , 2012, Investigative ophthalmology & visual science.

[32]  David Huang,et al.  Doppler optical coherence tomography of retinal circulation. , 2012, Journal of visualized experiments : JoVE.

[33]  A. Ho,et al.  Color Doppler imaging: a new technique to assess orbital blood flow in patients with diabetic retinopathy. , 1995, Investigative ophthalmology & visual science.

[34]  J. Fujimoto,et al.  Reproducibility of nerve fiber layer thickness measurements using optical coherence tomography. , 1996, Ophthalmology.

[35]  David Huang,et al.  Does optic nerve head size variation affect circumpapillary retinal nerve fiber layer thickness measurement by optical coherence tomography? , 2012, Investigative ophthalmology & visual science.

[36]  S. Srinivas,et al.  Pilot study of Doppler optical coherence tomography of retinal blood flow following laser photocoagulation in poorly controlled diabetic patients. , 2013, Investigative ophthalmology & visual science.

[37]  H. Littmann [Determination of the real size of an object on the fundus of the living eye]. , 1982, Klinische Monatsblatter fur Augenheilkunde.

[38]  J. Izatt,et al.  Measurement of total blood flow in the normal human retina using Doppler Fourier-domain optical coherence tomography , 2009, British Journal of Ophthalmology.

[39]  Paul Latkany,et al.  Ocular perfusion abnormalities in diabetes. , 2002, Acta ophthalmologica Scandinavica.

[40]  David Huang,et al.  Dual-Angle Protocol for Doppler Optical Coherence Tomography to Improve Retinal Blood Flow Measurement , 2014 .

[41]  J. Duker,et al.  Imaging of macular diseases with optical coherence tomography. , 1995, Ophthalmology.