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      Age-Related Alterations in Retinal Tissue Perfusion and Volumetric Vessel Density

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          Abstract

          Purpose

          To determine age-related alterations in the retinal tissue perfusion (RTP) and volumetric vessel density (VVD) in healthy subjects.

          Methods

          Total 148 healthy subjects (age 18 to 83 years) were enrolled and divided into four groups (G1, <35 years; G2, 35 ∼ 49 years; G3, 50 ∼ 64 years; and G4, ≥65 years). The RTP and VVD were measured at the macula. The RTP was calculated as the blood flow supplying the macular area (ϕ 2.5 mm) divided by the perfused tissue volume of the inner retina from the inner limiting membrane to the outer plexiform layer. The VVD of the macula (ϕ 2.5 mm) was calculated as the vessel density divided by the corresponding tissue volume.

          Results

          The RTP and VVD of the retinal vascular network and deep vascular plexus (DVP) reached a peak in G2. Compared to G2, G4 had significantly lower RTP and VVD of DVP ( P < 0.05). After 35 years old, age was negatively related to the RTP ( r = −0.26, P = 0.02) and VVD of the DVP ( r = −0.47, P < 0.001). However, age was positively related to VVD of the superficial vascular plexus (SVP; r = 0.24, P = 0.04) in subjects aged more than 35 years. The RTP was correlated to VVD measurements ( r = 0.23–0.37, P < 0.01).

          Conclusions

          This is the first study to reveal the age-related alterations in the RTP and VVD during normal aging in a healthy population. Decreased RTP and VVD in the DVP along with increased VVD in the SVP may represent a characteristic pattern of normal aging in the healthy population.

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          Most cited references17

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          Energy metabolism of the visual system.

          The visual system is one of the most energetically demanding systems in the brain. The currency of energy is ATP, which is generated most efficiently from oxidative metabolism in the mitochondria. ATP supports multiple neuronal functions. Foremost is repolarization of the membrane potential after depolarization. Neuronal activity, ATP generation, blood flow, oxygen consumption, glucose utilization, and mitochondrial oxidative metabolism are all interrelated. In the retina, phototransduction, neurotransmitter utilization, and protein/organelle transport are energy-dependent, yet repolarization-after-depolarization consumes the bulk of the energy. Repolarization in photoreceptor inner segments maintains the dark current. Repolarization by all neurons along the visual pathway following depolarizing excitatory glutamatergic neurotransmission preserves cellular integrity and permits reactivation. The higher metabolic activity in the magno- versus the parvo-cellular pathway, the ON- versus the OFF-pathway in some (and the reverse in other) species, and in specialized functional representations in the visual cortex all reflect a greater emphasis on the processing of specific visual attributes. Neuronal activity and energy metabolism are tightly coupled processes at the cellular and even at the molecular levels. Deficiencies in energy metabolism, such as in diabetes, mitochondrial DNA mutation, mitochondrial protein malfunction, and oxidative stress can lead to retinopathy, visual deficits, neuronal degeneration, and eventual blindness.
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            • Article: not found

            Macular perfusion in healthy Chinese: an optical coherence tomography angiogram study.

            To investigate macular perfusion in healthy Chinese individuals and examine its dependence on age and sex.
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              Cerebral blood flow, blood volume and oxygen utilization. Normal values and effect of age.

              Regional cerebral blood flow (CBF), oxygen extraction ratio (OER), oxygen utilization (CMRO2) and blood volume (CBV) were measured in a group of 34 healthy volunteers (age range 22-82 yrs) using the 15O steady-state inhalation method and positron emission tomography. Between subjects CBF correlated positively with CMRO2, although the interindividual variability of the measured values was large. OER was not dependent on CMRO2, but highly negatively correlated with CBF. CBV correlated positively with CBF. When considering the values of all the regions of interest within a single subject, a strict coupling between CMRO2 and CBF, and between CBF and CBV was found, while OER was constant and independent of CBF and CMRO2. In 'pure' grey and white matter regions CMRO2, CBF and CBV decreased with age approximately 0.50% per year. In other regions the decline was less evident, most likely due to partial volume effects. OER did not change or showed a slight increase with age (maximum in the grey matter region 0.35%/yr). The results suggest diminished neuronal firing or decreased dendritic synaptic density with age.
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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest. Ophthalmol. Vis. Sci
                iovs
                Invest Ophthalmol Vis Sci
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                February 2019
                : 60
                : 2
                : 685-693
                Affiliations
                [1 ]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
                [2 ]Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
                [3 ]Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, United States
                [4 ]Department of Ophthalmology, Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
                Author notes
                Correspondence: Jianhua Wang, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 1638 NW 10th Avenue, McKnight Building, Room 202A, Miami, FL 33136, USA; jwang3@ 123456med.miami.edu .
                Article
                iovs-60-02-13 IOVS-18-25864R2
                10.1167/iovs.18-25864
                6383727
                30786280
                800c5536-68d1-4fbb-9a6a-16a7f4516efa
                Copyright 2019 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 1 October 2018
                : 15 January 2019
                Categories
                Retina

                age,retina,retinal microcirculation,retinal tissue perfusion (rtp),volumetric vessel density (vvd)

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