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Marco Lupidi, Felice Cardillo Piccolino, Carlo Cagini, Roberta Corbucci, Daniela Fruttini, Massimo Nicolò, Chiara Eandi; Hemodynamics of Neovascular Central Serous Chorioretinopathy: a Stress/Rest Optical Coherence Tomography-Angiography Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3074.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate by optical coherence tomography angiography (OCT-A) the vascular response of macular neovascularization (MNV) to an experimentally increased blood pressure (BP) in patients with chronic central serous chorioretinopathy (CSCR).
In this multicenter, observational study, 32 patients with an established diagnose of neovascular CSCR were enrolled. All subjects underwent a hand-grip isometric test (HGT) for three minutes. In the resting phase and during the physical effort macular OCT-A scans were acquired using the Spectralis OCT-A. Systemic hemodynamic data were recorded at baseline and during stress conditions using an electronic sphygmomanometer. On OCT-angiograms qualitative and fully automated quantitative analyses of the MNVs were performed. The results were then correlated with those of the hemodynamic assessment.
Under stress data of systolic BP, diastolic BP, mean arterial pressure (MAP) and ocular perfusion pressure (OPP) were significantly higher (p<0.05) than baseline ones, reaching values in the range of hypertension. The qualitative analysis of MNV OCT-angiograms evidenced numerous microcirculatory changes during the HGT. A significant increase (p<0.05) of MNV area and fractal dimension and a significant reduction of the lacunarity index were seen in all MNV lesions during the HGT. Mean values of baseline MAP and OPP showed a positive linear correlation with the vascular perfusion density of the MNVs.
Results of the present study suggest that during physical stress patients with this neovascular CSCR easily reach critical values of blood pressure that have a direct impact on MNV perfusion. This phenomenon might potentially increase the risk of an actively exudating neovascular lesion.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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