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Effects of long-term high-altitude exposure on retinal and choroidal microcirculation

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To quantify the effect of long-term high-altitude (HA) exposure on retinal and choroidal microcirculation and to relate these changes to high-altitude polycythemia (HAPC), as a proxy for etiopathogenesis of high-altitude related retinopathy (HAR).

Methods

Fifty-one HAPC patients, 50 healthy HA residents, and 43 low altitude (LA) residents were recruited in this study. Optical coherence tomography angiography (OCTA) and enhanced depth imaging (EDI)-OCT images were analyzed. Retinal microvascular metrics included vessel density (VD), skeleton density (SD), fractal dimension (FD), and foveal avascular zone (FAZ). Choroidal microvascular metrics included subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI). All metrics were calculated by ImageJ software and compared among HAPC group, healthy HA group, and LA group.

Results

In HAPC group, VD (30.62 ± 3.67%), SD (13.25 ± 1.64%), FD (1.79 ± 0.04), and the CVI (63.01 ± 1.42%) were significant lower and SFCT (403.25 ± 94.3 μm) was significant thicker than healthy HA group (all P < 0.001). FAZ area was comparable between two groups (0.42 ± 0.1 vs. 0.4 ± 0.11 mm2, P = 0.411). However, these metrics were not different between healthy HA group and LA group (all P > 0.05) except for FD was lower in HA group (P < 0.001). Pearson’s correlation analyses revealed HGB was negatively related with VD (r =  − 0.562, P < 0.001) and positively related with SFCT (r = 0.505, P < 0.001) in healthy HA group; however, no associations between HGB and vascular metrics in HAPC group were detected (all P > 0.05).

Conclusions

Long-term exposure to HA environment induces retinal and choroidal microcirculation disturbance in HAPC patients. However, these changes were not evident in healthy HA residents because of adaptation.

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Data availability

All data are available, support published claims, and comply with field standards.

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Acknowledgements

The authors thank the subjects who participated in the study. We gratefully acknowledge those who helped us to prepare this research. This article received support from the mentorship team. Further information can be found in the editorial: https://bit.ly/3a7ltPx

Funding

This study was funded by technology research plan from the Department of Science and Technology of Qinghai Province (grant number 2019-ZJ-7064).

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Authors and Affiliations

  1. Department of Health Care, Qilu Hospital, Cheeloo College of Medicine, Shandong University, No. 107, Wenhuaxi Road, Jinan, 250012, China

    Jinlan Ma & Yi Qu

  2. Department of Ophthalmology, Affiliated Hospital of Qinghai University, Xining, China

    Jinlan Ma, Haoyu Niu & Changjing Han

  3. Department of Ophthalmology, Haidong First People’s Hospital, Pingan, China

    Xiaolu Ma

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  1. Jinlan Ma
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Contributions

MJL and QY contributed to design, data collection, and analysis, generating the figures, data interpretation, as well as preparation of the manuscript. MJL and HCJ contributed to data analysis and data interpretation and provided major revisions to the manuscript. MJL, MXL, and NHY contributed to the data collection as well as the analysis of data. QY contributed to the study design, study analysis, writing of the discussion, and revision of the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Yi Qu.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Qilu Hospital and Affiliated Hospital of Qinghai University and with the 1964 Helsinki declaration.

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The authors declare no competing interests.

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Informed consent was obtained from all individual participants included in the study.

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This article received support from the mentorship team. Further information can be found in the editorial https://link.springer.com/article/10.1007/s00417-019-04518-5 .

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Ma, J., Niu, H., Ma, X. et al. Effects of long-term high-altitude exposure on retinal and choroidal microcirculation. Graefes Arch Clin Exp Ophthalmol 260, 3525–3532 (2022). https://doi.org/10.1007/s00417-022-05699-2

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  • DOI: https://doi.org/10.1007/s00417-022-05699-2

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