Deep Vascular Imaging in the Eye with Flow-Enhanced Ultrasound

Summary

We present a non-invasive ultrasound technique for generating three-dimensional angiographies in the eye without the use of contrast agents.

Abstract

The retina within the eye is one of the most energy-demanding tissues in the body and thus requires high rates of oxygen delivery from a rich blood supply. The capillary lamina of the choroid lines the outer surface of the retina and is the dominating source of oxygen in most vertebrate retinas. However, this vascular bed is challenging to image with traditional optical techniques due to its position behind the highly light-absorbing retina. Here we describe a high-frequency ultrasound technique with subsequent flow-enhancement to image deep vascular beds (0.5-3 cm) of the eye with a high spatiotemporal resolution. This non-invasive method works well in species with nucleated red blood cells (non-mammalian and fetal animal models). It allows for the generation of non-invasive three-dimensional angiographies without the use of contrast agents, and it is independent of blood flow angles with a higher sensitivity than Doppler-based ultrasound imaging techniques.

Introduction

The high metabolism on the vertebrate retina imposes an intrinsic tradeoff between two contrasting needs; high blood flow rates and a light path devoid of blood vessels. To avoid visual disturbance of perfusing red blood cells, the retina of all vertebrates receives oxygen and nutrients via a sheet of capillaries behind the photoreceptors, the choriocapillaris^1,2,3. However, this single source of nutrients and oxygen imposes a diffusion limitation to the thickness of the retina^4,5, so many visually active species poss....

Protocol

The protocol below was performed with permission from the Danish Inspectorate for Animal Experimentation within the Danish Ministry of Food, Agriculture, and Fisheries, Danish Veterinary and Food Administration (Permit number 2016-15-0201-00835).

1. Anesthesia and ultrasound medium

1. Anesthetize the research animal.
   NOTE: Type and dose of appropriate anesthesia are highly species-dependent. In general, immersion-based anesthetics such as MS-222 (ethyl 3-aminobenzoate methanesulfonic acid), benzocaine (ethyl 4-aminobenzoate), and propofol (2,6-diisopropyl phenol) are useful in fish and amphibians which readily absorbs the anes....

Results

The flow-enhanced ultrasound technique to image vascular beds of the eye can be applied in a range of species and has currently been used in 46 different vertebrate species (Figure 1, Table 1). The presence of nucleated red blood cells in non-adult-mammalian vertebrates provides positive contrast of flowing blood compared to static tissue in cine recordings (Supplementary File 2). However, when analyzed on a frame-by-frame basis, the clear distinction betwee.......

Discussion

Vascular imaging using flow-enhanced ultrasound provides a new method for non-invasive imaging of the vasculature of the eye that offers several advantages over present techniques but has its intrinsic limitations. The primary advantage of flow-enhanced ultrasound is the ability to generate ocular angiographies with a depth of field that exceeds the retinal pigment epithelium, which limits the depth of field in optical techniques. In ultrasound imaging, spatial resolution and depth of field are ultimately determined by t.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
MS-222	Sigma	E10521-50G
Benzocaine	Sigma	E-1501
Propofol	B Braun	12260470_0320
Alfaxalon	Jurox	NA
Isoflurane	Zoetis	50019100
Ultrasound scanner	VisualSonics	Vevo 2100