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      • Record: found
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      Ocular circulation change in optic disc melanocytoma – a case report and a review of the literature

      case-report

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          Abstract

          Background

          Ocular circulation in optic disc melanocytoma (ODM) has not yet been well evaluated. We quantitatively evaluated longitudinal changes in the morphology and circulation hemodynamics of the disc and macula using optical coherence tomography angiography (OCTA) and laser speckle flowgraphy (LSFG) in a patient with optic disc melanocytoma.

          Case presentation

          A 50-year-old woman was referred to our hospital due to a dark pigmented tumor over the superior optic disc area of the left eye noted on physical examination. At the first visit, the patient’s best-corrected visual acuity (BCVA) was 20/20 in both eyes, and the intraocular pressure (IOP) was 17 and 18 mmHg in the left and right eyes, respectively. Fluorescein angiography (FA) showed blockage of fluorescence in the topography of the lesion, and indocyanine green angiography (ICGA) showed hypofluorescence at all times. On LSFG, a low mean blur rate (MBR) was noted in the optic disc all area (MBRa) and tissue (MBRt) compared to the contralateral eye at the first visit and at the 3-month follow-up. A relatively low MBR was also detected in the macular area of the affected eye and the tumor itself. OCTA detected blood vessel networks in the deep retinal layer of the tumor. The visual field showed no specific defects. During follow-up, there was no tumor enlargement or vision decrease.

          Conclusions

          We found that a lower MBR of the disc and macula area was noted on LSFG in this patient with optic disc melanocytoma, and it was continually observed at the 3-month follow-up. Although blood vessel networks in the deep retinal layer of the tumor were detected by OCTA, vascular compromise in the surrounding disc area and macula was found. Therefore, these results further increase our knowledge about the role that circulation impairment plays in the pathogenesis of the disease while vision is unaffected.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12886-023-02785-9.

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          Most cited references22

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          Reproducibility of retinal circulation measurements obtained using laser speckle flowgraphy-NAVI in patients with glaucoma

          Naoko Aizawa, Yu Yokoyama, Naoki Chiba … (2011)
          Background: Laser speckle flowgraphy (LSFG) enables noninvasive quantification of the retinal circulation in glaucoma patients. In this study, we tested the intrasession reproducibility of LSFG-NAVI, a modified LSFG technique. Methods: Sixty-five eyes from 33 subjects (male (M):female (F) = 17:16) with a mean age of 49.4 ± 11.2 years were examined in this study. Two parameters indicating reproducibility – the coefficient of variation (COV) and the intraclass correlation coefficient (ICC) – were analyzed three times on the same day that mean blur rate (MBR) was measured using LSFG-NAVI. The sites analyzed were the retinal artery and vein, the optic disk, and the choroid. Following classification according to the Glaucoma Hemifield Test (GHT; SITA-Standard 30-2 program), the COV and ICC were examined in patients with (GHT+; 38 eyes, M:F = 20:18, average age 48.9 ± 12.8 years) and without (GHT−; 27 eyes, M:F = 13:14, average age 50.1 ± 8.7 years) abnormal glaucomatous visual fields. Results: For all subjects, the intrasession reproducibility of MBR in the optic disk (COV: 3.4 ± 2.0; ICC: 0.95) and choroid (COV: 4.7 ± 3.4; ICC: 0.98) was excellent. The reproducibility for the retinal vein (COV: 8.4 ± 5.6, ICC: 0.90) and retinal artery (COV: 10.9 ± 9.9, ICC: 0.9) was moderate. MBRs in the optic disk had good reproducibility in both the GHT+ group (COV: 3.8 ± 2.0; ICC: 0.97) and the GHT− group (COV: 2.9 ± 2.1; ICC: 0.95). Local assessment of the optic disk in normal or glaucoma patients showed that the COVs of the quadrant optic disk areas were best in the temporal area of MBR (3.4%, 4.2%, respectively). Conclusion: LSFG-NAVI showed favorable reproducibility in evaluation of retinal circulation of glaucoma patients, particularly in the optic disk and choroid.
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            Noncontact, two-dimensional measurement of retinal microcirculation using laser speckle phenomenon.

            H. Fujii, M Araie, E Kawamoto … (1994)
            To report a new apparatus for noncontact, two-dimensional measurement of retinal microcirculation using the laser speckle phenomenon and to demonstrate that this apparatus can document known or expected changes in retinal blood flow. The rabbit fundus was illuminated by an argon (blue) laser spot (0.62 x 0.62 mm), and its image speckle was detected with an image sensor. The difference between the average of the speckle intensity (Imean) and the speckle intensity for successive scannings was calculated, and the ratio of Imean to this difference was defined as normalized blur (NB), a quantitative index of blood velocity in the retinal microcirculation. The results were displayed on a color monitor showing the two-dimensional variation of the NB level in the measurement area. Using this apparatus in the rabbit, the NB in the retinal field free of visible surface vessels was determined and compared with the retinal blood flow rate measured using the microsphere technique in the same eye simultaneously. In addition, the effect of the ocular perfusion pressure (OPP) on NB was studied. In the above experiments, a stepwise reduction in OPP was introduced by elevating the intraocular pressure manometrically. The relative decrease in the average NB (NBav) over the field measured, with the reduction in OPP, showed significant correlation with the relative change in the blood flow rate determined using the microsphere technique (r = 0.59, P < 0.001). Although NBav in the retina was little affected by OPP change when OPP was greater than 50 mm Hg, NB decreased along with OPP at levels less than 50 mm Hg. The NBav showed significant correlation with the retinal blood flow rate determined with microsphere technique. Retinal microcirculation under various conditions can be studied two dimensionally and noninvasively in the living eye with the present apparatus.
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              Effect of acute decreases of perfusion pressure on choroidal blood flow in humans.

              P Titze, C Riva, B Petrig … (1997)
              To investigate the relationship between choroidal blood velocity (ChBVel), blood volume (ChBVol) and blood flow (ChBF) in the foveal region of the human ocular fundus and ocular perfusion pressure and to determine whether the choroidal circulation has some autoregulatory capacity. Measurements of ChBVel, ChBVol and ChBF were obtained by laser Doppler flowmetry in healthy subjects (age range, 21 to 57 years) with normal eye examination results. Measurements were performed at normal intraocular pressure (IOP) and during successive step increases in IOP induced by scleral suction. In experiment 1, in six eyes (five subjects), the IOP was increased rapidly, in steps of 50 to 100 mm Hg of suction pressure, which each lasted approximately 10 seconds to a level above diastolic ophthalmic artery blood pressure (IOP = approximately 72 mm Hg). In experiment 2, in 14 eyes (seven subjects), the IOP was increased slowly in four successive steps at 2-minute intervals to a level of approximately 42 mm Hg. We also determined the pulsatility of the flow parameters during the heart cycle, pulsatility = 1 - diast value/syst value. For both rates of suction cup increase, the relationship between ChBFm (mean ChBF over the heart cycle) and mean perfusion pressure was not linear. At high pressure, ChBFm was less affected by decreases in the pressure than expected from a passive vascular system. In some cases, no change in ChBFm was detectable, although significant changes in PChBF occurred. Further decreases in perfusion pressure resulted in a proportional decrease in ChBFm. On release of suction, a significant increase in ChBFm over baseline value was detectable in experiment 1. The relationship between ChBFm and ocular mean perfusion pressure appears to be bilinear and reveals some autoregulation for moderate step decreases in perfusion pressure. The temporal characteristics of the ChBFm-response suggest a neural or passive hemodynamical process rather than a myogenic or metabolic compensatory mechanism.
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                Author and article information

                Contributors
                Yi-Lin Liao:
                ORCID: http://orcid.org/0000-0001-8061-1052
                yilinliao@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Ophthalmol
                Journal ID (iso-abbrev): BMC Ophthalmol
                Title: BMC Ophthalmology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2415
                Publication date (Electronic): 23 January 2023
                Publication date PMC-release: 23 January 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 33
                Affiliations
                [1 ]GRID grid.413801.f, ISNI 0000 0001 0711 0593, Department of Ophthalmology, , Chang Gung Memorial Hospital, ; Linkou, Taiwan
                [2 ]GRID grid.145695.a, ISNI 0000 0004 1798 0922, Department of Medicine, College of Medicine, , Chang Gung University, ; Taoyuan, Taiwan
                Author information
                http://orcid.org/0000-0001-8061-1052
                Article
                Publisher ID: 2785
                DOI: 10.1186/s12886-023-02785-9
                PMC ID: 9869588
                PubMed ID: 36690981
                SO-VID: bd3d1486-96fc-4ef9-a5cf-e2a1671e418e
                Copyright © © The Author(s) 2023
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 22 June 2022
                Date accepted : 13 January 2023
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2023

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: optic disc melanocytoma,ocular circulation,optical coherence tomography angiography,laser speckle flowgraphy,case report
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: optic disc melanocytoma, ocular circulation, optical coherence tomography angiography, laser speckle flowgraphy, case report

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