Effect of Premature Acute Coronary Syndrome on Ocular Hemodynamics

Figures

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  Figure 1. Ophthalmic artery (OA) three-dimensional reconstruction and morphological measurement. (A) The process of OA reconstruction; ICA, internal carotid artery. (B) The initial OA diameter measurement. (C) Angle measurement between OA and ICA. (D) Measurement of the OA tortuosity.

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  Figure 2. Hemodynamics characteristics of ophthalmic artery (OA). (A) The streamlines are colored according to the magnitude of velocity in three typical patients; Comparison of OA blood velocity. (B) The wall shear stress contour of OA in three typical patients; Comparison of OA wall shear stress. (C) The pressure contour of OA in three representative models; Comparison of OA pressure. (D) Mass flow (kg/s) and mass flow ratio of the OA to ipsilateral internal carotid artery (%) of three representative models; Comparison of mass flow ratio of OA to ipsilateral internal carotid artery (%); Inlet (+), outlet (-), Blood flow direction (black arrow). ACS, acute coronary syndrome; HC, healthy controls; PACS, premature ACS; NPACS, non- premature ACS.

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  Figure 3. Sample case (left eye) for premature ACS group. (A) The streamlines are colored according to the magnitude of the ophthalmic artery (OA) velocity. (B) The wall shear stress contour of OA. (C) The pressure contour of OA. (D) Mass flow (kg/s) and mass flow ratio of the OA to ipsilateral internal carotid artery (%); Inlet (+), outlet (-), Blood flow direction (black arrow). (E) Quantitative analysis of retinal vessel caliber by Integrative Vessel Analysis (IVAN software, Australia); veins are identified in purple and arteries in red; in this case, the central retinal artery equivalent value is 125.89mm, central retinal vein equivalent value is 224.34mm, and arteriole to venule ratio value is 0.56. (F) Choroidal vascularity index (CVI) in the whole choroid region; total choroidal area (TCA) and luminal area (LA) were measured using a binarized image; overlay image of enhanced depth imaging optical coherence tomography scan with region of interest obtained after image binarization; yellow pixels represent stroma and black pixel represent vascular lumen; CVI was determined by dividing TCA by LA; in this case, the CVI value is 0.31. (G) CVI within 1500μm of central fovea is 0.33.

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  Figure 4. Sample case (right eye) for non-premature ACS group. (A) The streamlines of the ophthalmic artery (OA). (B) The wall shear stress contour of the OA. (C) The pressure contour of the OA. (D) Mass flow (kg/s) and mass flow ratio of the OA to ipsilateral internal carotid artery (%); Inlet (+), outlet (-), Blood flow direction (black arrow). (E) Quantitative analysis of retinal vessel caliber by Integrative Vessel Analysis (IVAN software, Australia); veins are identified in purple and arteries in red; in this case, the central retinal artery equivalent value is 134.58mm, central retinal vein equivalent value is 226.67mm, and arteriole to venule ratio value is 0.59. (F) Choroidal vascularity index (CVI) in the whole choroid region; total choroidal area (TCA) and luminal area (LA) were measured using a binarized image; overlay image of enhanced depth imaging optical coherence tomography scan with region of interest obtained after image binarization; yellow pixels represent stroma and black pixel represent vascular lumen; CVI was determined by dividing TCA by LA; in this case, the CVI value is 0.38. (G) CVI within 1500μm of central fovea is 0.34.

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  Figure 5. Correlation between ophthalmic artery (OA) hemodynamic variables and clinical parameters of patients with ACS. TG, triacylglycerol; NT-proBNP, N-terminal pro-B-type natriuretic peptide; LVEF, left-ventricular ejection fraction; CK-MB, creatine kinase isoenzyme-MB; HBA1c, hemoglobin A1c; ICA, internal carotid artery; ln, natural log of the variable.