Auflistung nach Autor:in "Schopmeyer, Lasse"

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Correlation of the SD-OCT staging system for glaucoma severity with intraocular and systemic endothelin-1 concentration and ocular blood flow impairment measured by OCT-angiography
(2025) Schopmeyer, Lasse
Introduction: This dissertation aimed to investigate the correlation between optical coherence tomography angiography (OCT-A) parameters, specifically vessel density (VD) in the optic nerve head (ONH) and foveal regions of glaucoma patients with the levels of the potent vasoconstrictor endothelin 1 (ET-1) and its precursor big ET-1 in both plasma and aqueous humour (AqH). Furthermore, the compatibility of OCT-A parameters with the optical coherence tomography (OCT) glaucoma staging system (OCT-GSS), previously validated only for OCT measurements, was explored. Materials and Methods: This prospective monocenter study included adult patients undergoing elective cataract or glaucoma surgery. Intraoperatively gathered AqH and plasma were collected from glaucoma patients and control patients. Glaucoma diagnosis was confirmed or excluded through medical history, intraocular pressure assessment, fundoscopy and spectral domain (SD) OCT imaging. Exclusion criteria encompassed low-quality imaging, systemic disease, vasoactive medication usage, as well as previous ophthalmologic surgery, except posterior chamber lens implantation, laser trabeculoplasty or laser iridotomy more than six months ago. ET-1 and big ET-1 levels were quantified using Enzyme-Linked-Immunosorbent-Assay (ELISA) and multiplex immunoassays, respectively. Protein levels were determined using the Bradford protein assay. Descriptive statistics were applied for dataset exploration, followed by linear correlation analysis. A multivariable regression analysis was subsequently conducted with appropriate variables. Results: Significantly elevated levels of ET-1 in both plasma and AqH were observed in glaucoma patients compared to the control group. Significant correlations were identified between plasma ET-1 levels and various OCT-A VD parameters in the ONH and foveal regions. No correlations were found for Big ET-1 levels. The OCT-GSS exhibited significant correlations with several OCT-A VD parameters, including the VD of the entire ONH and the VD of the entire macula superficial vascular plexus (SVP). Discussion: The detected correlations between plasma ET-1 levels and OCT-A parameters suggest a potential novel diagnostic criterion for early detection and assessment of glaucomatous damage, potentially surpassing the capabilities of SD-OCT. The findings support the theory of a systemic pathology in primary open-angle glaucoma (POAG), rather than the concept of a local disease. The correlation of OCT-A parameters with the OCT-GSS suggests that integrating OCT-A analysis into this staging system could potentially enable enhanced early detection and greater sensitivity.