July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
A theoretical study of vascular configurations of retinal capillary plexi based on OCTA data
Author Affiliations & Notes
  • Greta Chiaravalli
    Politecnico di Milano , Sumirago, Italy
  • Giovanna Guidoboni
    University of Missouri, Missouri, United States
  • Riccardo Sacco
    Politecnico di Milano , Sumirago, Italy
  • Thomas A Ciulla
    Eye Clinic of Lithuanian University of Health Sciences, Lithuania
  • Alon Harris
    Ophtalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Footnotes
    Commercial Relationships   Greta Chiaravalli, None; Giovanna Guidoboni, None; Riccardo Sacco, None; Thomas Ciulla, Clearside Bio (E), Clearside Bio (I); Alon Harris, AdOM (I), AdOM (C), CIPLA (C), Oxymap (I), Shire (C)
  • Footnotes
    Support  University of Missouri
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 149. doi:
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    • Get Citation

      Greta Chiaravalli, Giovanna Guidoboni, Riccardo Sacco, Thomas A Ciulla, Alon Harris; A theoretical study of vascular configurations of retinal capillary plexi based on OCTA data. Invest. Ophthalmol. Vis. Sci. 2019;60(9):149.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Optical coherence tomography angiography (OCTA) has made available a huge amount of imaging data regarding the superficial (SCP), intermediate (ICP) and deep (DCP) capillary plexi in the retina. However, their interpretation is not unanimous: the question of whether capillary plexi are connected in series (S) or in parallel (P) remains a matter of debate (Campbell et al 2016; Fouquet et al 2017). To address this question, we utilize a mathematical model to quantify the impact on hemodynamics and oxygenation associated with S and P vascular configurations (denoted by Sconf and Pconf) (FIG 1)

Methods : The retinal vasculature is modeled via an hydraulic-electric analogy, where the two configurations are tested (FIG 1). Model parameters are based on OCTA data. The capillary flow computed with the model provides an oxygen (O2) source within the tissue, where, given the metabolic consumption, we calculate the O2 levels. The model simulates how retinal hemodynamics and oxygenation would change in the cases of central retinal vein occlusion (CRVO) (FIG 2A) and IOP elevation (IOP-el) (FIG 2B), depending on whether Sconf or Pconf are considered

Results : CRVO is simulated by reducing the CRV radius in FIG 1. The results reported in FIG 2A show that:(i) in the Sconf, the plexi exhibit a differential response, with DCP and ICP experiencing larger pressure drops than SCP;(ii) in the Pconf, the blood flow redistributes uniformly across them. The Sconf results are coherent with studies on paracentral acute middle maculopathy (Garrity et al 2017; Sarraf et al 2013), where, secondary to CRVO, DCP and ICP are affected by ischemia. In the Sconf, the O2 profiles of the outer nuclear layer (ONL), outer plexiform layer (OPL) and inner nuclear layer (INL) are those most affected by CRVO, whereas INL and glanglion cell layer (GCL) in the P-conf. The simulated O2 levels are positive until reaching a CRVO of 80%. Similar results are obtained upon elevating IOP (FIG 2B-top): Sconf results are coherent with clinical studies on IOP-el (Bui et al 2018)

Conclusions : Mathematical modeling allowed us to simulate two possible vascular configurations of the retinal capillary plexi, thereby aiding the interpretation of OCTA data. Results suggest that S-conf better describes the physiology of the retinal vasculature

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Schematic of retinal vascular model

Schematic of retinal vascular model

 

Simulated hemodynamic and oxygenation changes due to CRVO and IOP-el in Sconf and Pconf

Simulated hemodynamic and oxygenation changes due to CRVO and IOP-el in Sconf and Pconf

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