Cardiovascular (CV) disease (CVD) is the main cause of death around the world, and assessing a patient's CV risk factors (CVRF) can play a major role in its prevention. Since it has been shown that retinal vascular alterations may reflect several systemic processes such as CVRF, we conducted a systematic review in order to summarize which ocular microvasculature changes can be found using Optical Coherence Tomography Angiography (OCTA) in patients without ocular diseases and with systemic pathologies/conditions that affect the CV system when compared to healthy subjects. We searched on online databases, namely PubMed, Scopus, Cochrane and Web of Science, and obtained additional studies through citation tracking. Case reports and review articles were excluded. A total of 47 articles were included in our review. We describe that patients with hypertension, diabetes mellitus, kidney disease, preeclampsia, coronary artery disease, carotid artery stenosis and obstructive sleep apnoea syndrome have, in general, lower retinal and choroidal Vessel Density (VD) and Length (VL), as well as an increased foveal avascular zone area and perimeter. Additionally, several characteristics and/or conditions in healthy subjects, such as smoking status, hyper or hypoxia conditions, race, among others, are also related to ocular vascular changes and should be accounted for. We concluded that OCTA could be a useful tool to assess a patient's CV risk profile in a non-invasive way, possibly integrating the diagnostic and prognostic algorithms of the most prevalent CV diseases in the future.

Optical coherence tomography angiography changes in cardiovascular systemic diseases and risk factors: A Review

ObjectiveTo assess the risk of fetal loss attributable to second-trimester amniocentesis.MethodsA cohort study was undertaken among singleton pregnant women undergoing genetic amniocentesis and controls matched prospectively on a one-to-one basis, matched strictly for maternal age, parity, and socio

Amniocentesis-Related Fetal Loss

Optical coherence tomography angiography in neuro-ophthalmology: Current clinical role and future perspectives.

Background In this paper, we evaluate the different thresholding strategies that have been used for the quantification of the choriocapillaris (CC) and explore their repeatability and the interchangeability of the measurements resulting from its application. Methods Observational study. Eighteen eyes from nine healthy volunteers aged >18 years were imaged four consecutive times with a SD-OCTA system (Heidelberg Engineering, Germany) using a 10°×10° high-resolution protocol centered on the fovea. Projection artifacts were removed, and the CC was bracketed between 10 and 30 µm below Bruch's membrane. For the quantification of CC, we used four flow deficits (FD) parameters: FD number, mean FD size, total FD area and FD density. We performed a systematic review of literature to collect the thresholding methods that have been used for the quantification of CC. The CC quantification parameters were then evaluated after applying each of the thresholding strategies. Intraclass correlation coefficient (ICC) and Pearson's correlation analysis were used to compare the repeatability and interchangeability among the different thresholding strategies for quantifying the CC. Results A total of 72 optical coherence tomography angiography (OCTA) examinations were considered. The systematic review allowed us to conclude that three local thresholding strategies (Phansalkar, mean and Niblack) and three global thresholding strategies (mean, default, Otsu) have been used for CC quantification. These strategies were evaluated in our observational study. We found a high agreement within the same method in the quantification of FD number, mean FD size, total FD area and FD density but a poor agreement with different strategies. Local strategies achieved a significantly superior ICC than global ones in CC quantification. Conclusions In conclusion, the interchangeability of the CC quantification using different thresholding strategies is low, and direct comparisons should not be performed. Local thresholding strategies are significantly superior to global ones for quantifying CC and should be preferred. There is an unmet need for a uniform strategy to quantify CC in future studies.

/pdf/evaluation-of-the-different-thresholding-strategies-for-57rr5nj3kj.pdf

Evaluation of the different thresholding strategies for quantifying choriocapillaris using optical coherence tomography angiography.

Background Amniocentesis is a well-known invasive procedure which is commonly carried out in the second trimester. The indication for amniocentesis varies throughout countries and centers. Despite providing significant prenatal diagnosis; many maternal and fetal complications have been reported from previous studies. Materials and methods This retrospective study aimed to determine the maternal and fetal complications following amniocentesis. This study involved all patients who underwent amniocentesis from January 2012 until June 2017 in a tertiary centre. Maternal age, parity, premorbid medical conditions, amniocentesis indications, gestational age during amniocentesis, karyotyping results, complications during and post procedure and the fetal outcomes were reviewed and analyzed. Results One hundred and fourteen patients' medical records were reviewed and the majority of patients (50.9%) ranged in age from age 30 to 39 years old with mean age of 34.29 years. Amniocentesis was performed during the second trimester in the majority of patients (71.1%). The indications for amniocentesis in this study were polyhydramnios (7.9%), advanced maternal age (9.6%), risk of Down's syndrome (31.6%), increased risk of Patau syndrome (6.1%), increased risk of Edward's syndrome (4.4%) and abnormal fetal ultrasonography (70.2%). Cytogenetics results of amniocentesis were normal in 82 patients (71.9%). The majority of patients (86.0%) had no complications. Two patients (12.5%) had intrauterine death presumed to be procedural related. Conclusion This 5-year retrospective study on amniocentesis procedure showed that the majority of amniocentesis were safe as 86.0% of the patients were free from any complications. Anticipating its complication is important as there is always a risk even though it is a safe procedure in general.

5-Year review on amniocentesis and its maternal fetal complications

Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography.

DOI: 10.4328/JCAM.4149 Received: 27.11.2015 Accepted: 11.12.2015 Printed: 01.03.2016 J Clin Anal Med 2016;7(2): 197-200 Corresponding Author: Önder Ercan, Kadın Hastalıkları ve Doğum ABD, Kahramanmaraş Sütçüimam Üniversitesi, 46100, Kahramanmaraş, Türkiye. GSM: +905058923996 F.: +90 3442804042 E-Mail: onderdrercan@hotmail.com Özet Amaç: Kliniğimizde son 5 yılda amniosentez yapılan hastalarda işleme bağlı fetal kayıp riskinin ve kötü gebelik sonuçlarının artıp artmadığını değerlendirmek. Gereç ve Yöntem: Bu retrospektif çalışma Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum kliniğinde 2011 Ocak ile 2015 Temmuz tarihleri arasında amniosentez yapılan 387 hastanın dosyalarından ve genetik merkezin kayıtlarından incelenerek yapıldı. Ayrıca kliniğimize kontrole gelen ve amniosentez yapılmayan düşük riskli 250 hasta kontrol grubu olarak belirlendi. Bulgular: Çalışma süresince amniosentez endikasyonu olan 688 hasta mevcuttu. Bunlardan 387 hastaya amniosentez yapıldı. %43.8 amniosentez reddetme oranı mevcuttu. En sık amniosentez endikasyonu anormal Down sendromu tarama testi iken (%57.6), 2. sıklıkla ileri maternal yaş (%22.5) görülmektedir. Amniosentez yapılan hastaların 24’ünde (%6.2) kromozomal anormallik mevcut olup bunlar içerisinde en sık Down sendromu izlendi (%54). Amniosentez sonrası fetal kayıp 2 hastada (%0.5) görülmüştür. Toplamda kötü gebelik sonuçlarına bakıldığında amniosentez yapılanlarda 8, kontrol grubunda 5 hastada kötü gebelik sonuçları izlenmiş olup gruplar arasında istatisitksel anlamlı fark yoktu (p=0.263). Tartışma: Amniosentez günümüzde sıklıkla kullanılan invaziv prenatal tanı testidir. İşleme bağlı olarak gebelik komplikasyonlarında bir artış görülmemektedir. Amniosentez öncesinde hastalara mutlaka yapılacak işlem ve sonuçları hakkında detaylı danışmanlık verilmelidir.

Does Amniocentesis Increase the Rates of Fetal Loss and Poor Pregnancy Outcomes

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Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography.

Does Amniocentesis Increase the Rates of Fetal Loss and Poor Pregnancy Outcomes