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Ahmet M Hondur, Mestan Ertop, Salih Topal, Burak Sezenoz, Tongalp H Tezel; Optical Coherence Tomography and Angiography of Choroidal Vascular Changes in Congestive Heart Failure. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3204.
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© ARVO (1962-2015); The Authors (2016-present)
This study aimed to investigate the changes in the choroidal vasculature induced by congestive heart failure (CHF) using optical coherence tomography angiography (OCT-A) and enhanced deep imaging (EDI) of the choroid with spectral domain optical coherence tomography (OCT).
EDI imaging with OCT was used to calculate the choroid thickness, choroidal vascularity index (CVI: choroidal vessels/total choroidal area) and the ratio of Haller’s layer to total choroidal thickness (Haller/choroid ratio) in 25 eyes of 25 patients with congestive heart failure. In the same cohort, choriocapillaris flow density was estimated with OCT-A. Correlation was sought between the structural values of the choroid and clinical correlates of CHF severity (ejection fraction in echocardiography, heart failure class, serum brain natriuretic factor level). Obtained values were also compared with a control group of 25 age, gender and refractive error-matched healthy individuals.
The choroidal thickness of the patients with CHF was not different from that of healthy control eyes. (231 mm versus 254 mm respectively, p=0.29).The CVI (0.53 vs 0.60, p=0.004) and choroiocapillaris flow density (0.67 vs 0.64, p=0.01) were reduced, while the Haller/choroid ratio (0.84 versus 0.70, p<0.001) was markedly increased in eyes with congestive heart failure compared to control eyes. However, choroidal vascular changes were not correlating with any of the clinical correlates of heart failure severity.
Congestive heart failure alters the blood flow in choroid leading to structural changes. Our data suggests pooling of venous blood in the Haller layer and subsequent compression of the inner choroid by stagnated blood flow in big vessels in CHF. Apart from pooling of venous blood in the choroid, various other factors may play a role for observed changes such as blood pressure, vascular risk factors, serum levels of mineralocorticoids and local production of vasoactive intestinal peptide.
This is a 2020 ARVO Annual Meeting abstract.
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